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Small practices: Decide whether reporting with GPRO is worth your time

01/18/2013

Practices of two or more providers can use the group practice reporting option (GPRO) for the physician quality reporting system (PQRS). But only individual measures are approved for the 2013 GPRO program; practices cannot report measures groups under GPRO.

Part B News brief

01/18/2013

News for certain providers in California.

Fiscal cliff bill has some bad news for providers: Longer look-back period, more cuts

01/14/2013

by: Roy Edroso

Be ready for auditors to look at two more years of claims after the American Taxpayer Relief Act extended the look-back period within which CMS can request providers return overpayments to five years.

E/M modifier changes and new TCM code pairs dominate Q1 CCI edits

01/14/2013

by: Lauren C. Williams and Laura Evans

Your coders will have to get familiar with nearly 40,000 new code pairs – far fewer than the 250,000 released in 2012’s fourth quarter – in CMS’ latest National Correct Coding Initiative (CCI) edits effective Jan. 1.

Fiscal cliff bill extends therapy cap changes, medical review through 2013

01/14/2013

by: Karen Long

You’ll have to append the KX modifier when patients exceed $1,900 therapy caps and undergo manual medical review when patients reach $3,700 therapy thresholds in calendar year 2013.

Report codes 30 days after discharge, watch timing of face-to-face visit

01/14/2013

by: Laura Evans

Now that Medicare has announced it will cover the new transitional care management (TCM) codes (99495-99496), primary care practices are assessing the post-discharge services they provide to see whether the new codes’ revenue would be worth the added work needed to bill them.

Think twice before buying advanced imaging equipment in light of cuts

01/14/2013

by: Roy Edroso

The cut to advanced imaging reimbursement in the fiscal-cliff-related American Taxpayer Relief Act passed this month takes until 2014 to kick in. But if your practice owns some of the heavy hardware that’s taking a hit, you might consider selling it before then.

Benchmark of the Week: Top physician specialties that lost money from denials, 2011

01/14/2013

by: Lauren C. Williams

The chart examines the top five physician specialties that saw the most denied claims in 2011 based on a Part B News analysis of 2011 Medicare claims data, the latest available.

Provider payments ‘fixed’ in fiscal cliff deal

01/07/2013

by: Part B News staff

Your Medicare payments are safe for another year from the ever-looming sustainable growth rate (SGR) cut. Congress’ “fiscal cliff” agreement — brokered and passed by the House and Senate on Jan. 1 — prevented the 26.5% SGR cut from going into effect as part of a larger legislative effort that also extended certain tax benefits.

PBN’s 2013 predictions: PQRS, e-Rx, ICD-10, Medicare uncertainty concerns

01/07/2013

by: Karen Long

The New Year will bring more Medicare reimbursement uncertainty, more providers jumping on the physician quality reporting system (PQRS) and e-prescribing (e-Rx) bandwagons and an earnest start to ICD-10 preparations at many practices, experts predict.

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