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6 key parts of CMS’ proposed complex chronic care plan to watch

08/05/2013

Though CMS has yet to set fees for new G-codes for complex chronic care services introduced in the proposed 2014 physician fee schedule, practices can look to six key points to determine whether they’ll be able to provide the services profitably.

Watch for higher Medicaid E/M, vaccine payments as states start doling them out

08/05/2013

by: Karen Long

Increased payments for Medicaid primary care services have started reaching providers more than six months after the two-year program began.

Avoid denials, overpayments with 5 tips for proper prolonged services billing

08/05/2013

by: Karen Long

Look at the total time of an E/M visit and whether it was dominated by counseling to know whether you are able to bill prolonged services codes.

Implement a 3-point approach to NPP diagnostic tests to avoid denials

08/05/2013

by: Jennifer Clampet

Don’t let confusing requirements for diagnostic tests performed by non-physician practitioners (NPPs) stop your office from pursuing a new revenue opportunity.

Benchmark: Denials up for longer in-office prolonged service codes, down for others

08/05/2013

by: Karen Long

Make sure you have complete documentation to support billing 99355 (Prolonged service in the office ... ; each additional 30 minutes) for at least 75 minutes of prolonged services because denial rates jumped to 35.5% in 2011 from 29.8% in 2010.

MACs demand repayment on ‘incarcerated’ patients but offer little help to track them

07/29/2013

by: Roy Edroso

A number of providers have been hit with demand letters and takebacks — one for more than $100,000 — from Medicare contractors for claims of patients who were allegedly “incarcerated” at the time of their treatment. Some of those patients may not have been incarcerated — but it’s up to providers to find the evidence of that and use it to appeal to the contractors.

Check whether administrative claims measures apply before signing up

07/29/2013

by: Laura Evans

If you are planning to register to have CMS report your Physician Quality Reporting System (PQRS) measures for you under the administrative claims-based option this year, look at the list of measures first, billing experts recommend.

Withstand auditor scrutiny with 7 ways to bolster your E/M documentation

07/29/2013

by: Roy Edroso

Check common problems and use physician education to keep your high-level E/M coding from getting out of hand and attracting the attention of Medicare administrative contractors (MACs).

5 tips for getting vendors’ ICD-10 timelines for software changes

07/29/2013

by: Jennifer Clampet

Medical practices and their vendor partners aren’t talking about ICD-10 — and that could be slowing down your preparations for the Oct. 1, 2014, coding changeover, say experts.

Benchmark of the Week: About 60% of practices well-informed but concerned about vendors’ ICD-10 plans

07/29/2013

Most practices feel at least somewhat well-informed about their vendors’ plans for ICD-10 software implementation, according to a recent Part B News survey of 133 readers.

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