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2016 fee schedule: Radiation therapy centers lose, indy labs win among specialties

11/23/2015

In 2016, the most striking change in “combined impact” is for radiation therapy centers, for which allowed charges had been estimated to increase in 2015 by 10% but will be reduced by 1% in 2016.

Experts: Respect rights of provider and patient when provider objects to ACP

11/16/2015

by: Roy Edroso

If a provider has a religious or moral objection to performing the new advance care planning (ACP) service, his or her conscience rights must be respected — but make sure the patient has an alternative.

Avoid denials, fraud by cutting back ‘exploding notes,’ other EHR gaffes

11/16/2015

by: Roy Edroso

An indictment for fraud based in part on misuse of electronic health record (EHR) macros is a warning that your use of such shortcuts may be leading your practice into danger.

Show evidence of distress if you changed EHR vendors and seek reporting exemption

11/16/2015

by: Richard Scott

Prepare for a new documentation requirement if you’ve recently switched electronic health record (EHR) vendors and you’re not able to meet meaningful use in 2015.

CMS adds an ‘alternate exclusion’ to meaningful use public health reporting

11/16/2015

by: Richard Scott

You’re eligible to claim an exclusion to two meaningful use public health reporting measures for stage 2 reporting in 2015, provided you previously didn’t intend to report to them.

Watch for HIPAA pitfalls when involving police in patient identification checks

11/16/2015

by: Marla Durben Hirsch

Be careful how you proceed if your practice wants to notify the police because you suspect that a patient has provided false information. You don’t want to be accused of violating HIPAA in the process.

Common services, big payments tied up in ICD-10 claims-processing errors

11/16/2015

by: Richard Scott

Since the ICD-10 code set launched Oct. 1, multiple CPT and HCPCS codes for common services and procedures have been wrapped up in ICD-10 claims-processing errors that are delaying payment to physician practices.

Follow new date-of-service rule for billing transitional care management

11/09/2015

by: Richard Scott

Don’t get too comfortable with your strategy for billing transitional care management (TCM) services — the 2016 physician fee schedule changes a key date-of-service requirement that you need to document to get your claims processed.

Study up on appropriate forms to secure $86 payment for advance care planning

11/09/2015

by: Roy Edroso

CMS reveals substantial payments for advance care planning (ACP) and an opportunity to bill it without copayment in the final 2016 Medicare physician fee schedule, but providers will have to spend time preparing to dispense the service properly.

Supervising physician should bill incident-to services, CMS clarifies

11/09/2015

by: Laura Evans

Only the physician or practitioner who directly supervises incident-to services may bill for those services, CMS states in the final 2016 Medicare physician fee schedule, released Oct. 30. However, the supervising physician need not be the provider who ordered or initiated the care, the agency explains.

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