Look for “practical tools,” such as checklists and decision trees, from CMS to prepare for ICD-10 implementation in 2014.

CMS also plans to hold an ICD-10 provider call Oct. 25 aimed at preparing physicians for the new code set.

Providers will have to wait until the end of that week for accurate data on patients’ therapy use, said George Mills, director of CMS’ provider compliance group, during a Sept. 26 call.

This chart depicts the utilization rate of established office visit code 99215for the 15 specialties that billed the code most often in 2010. Based on a Part B News analysis of Medicare claims data from 2010, 2006 and 2001, the graph compares the three years’ utilization rates for each specialty.

When a peripherally inserted central catheter (PICC) line is placed, it is standard practice to do a chest X-ray to confirm placement. Is it appropriate to bill for the chest X-ray in addition to the PICC line insertion?

Promote your patients’ positive experiences to the community through ads and social media campaigns to counteract the loss of patient visits from the growing number of retail health clinics. Some of those clinics, usually found at pharmacies, are beginning to expand into chronic disease management, possibly posing a threat to your patient base.

Weed out any potential electronic health records (EHR) meaningful use attestation issues now, in the final days before the 90-day reporting period begins on Oct. 1, to ensure you receive your $18,000 bonus without any hiccups. A host of problems can arise during the 90 days while others can be solved with staff training and workflow shuffling.

Your coders will have to get familiar with nearly 250,000 new code pairs – a hundred times more than were released in the third quarter – in CMS’ latest National Correct Coding Initiative (CCI) edits effective Oct. 1. The majority of added edit pairs have been related to general surgery and trigger point injections. Plus, all edit pairs, except for Category III pairs, were coupled with wound repair codes.

Your private pay rates change at least every year without the same consistency and reliability that comes with Medicare’s annual fee schedule. And if you’re not keeping track, you’re losing money. Keep more revenue by monitoring your private payer reimbursements and maintaining your own fee schedules for all payers.

This chart shows the Medicare services with the highest improper payment rates along with the percentage of overall Medicare fee-for-service improper payments that service’s improper payments represent. The data, which come from CMS’ 2011 Comprehensive Error Rate Testing (CERT) report released in August, include both underpayments and overpayments, although the majority were overpayments.

How do you correctly code Procrit (Epoetin alpha) for patients who don’t have end stage renal disease (ESRD)? Does the coding differ if the facility is a federally qualified health clinic?