As times continue to be tight, you must identify and plug revenue leaks, experts say. You have the same major potential sources of recoverable revenue regardless of practice size, says Ron Rosenberg, CEO of the Practice Management Resource Group in Tinley Park, Ill. While there are many ways you can lose earned revenue, they generally fall into these three categories.

Use physician office billing data from CMS to determine which preventive services are frequently done for the patients in your billing locality and the average amount your peers charge in your area. CMS has updated its Physician Payment Information for Value Driven Health Care files.

Anyone who thinks it's an absolute certainty that Congress will step in and stop the pay cuts coming this December and January is "smoking funny weed," Medical Group Management Association (MGMA) president William Jessee, MD, said at a media lunch during the group's recent conference in New Orleans. You've been on a roller coaster of payment cuts, freezes and minor increases for years, with Congress stepping in at the last minute to save the day. But this time around, a disenfranchised electorate, poor economic conditions and a $330 billion cost makes the fix less certain, Jessee believes.

CMS finalized the 2011 Medicare Physician Fee Schedule -- and it's not pretty. The conversion factor used to calculate Medicare services will be $25.5217, down 30.78% from $36.8729. We'll have a comprehensive analysis by Thursday night, but for now, feast your eyes on these top highlights from the final rule, based on an exclusive preliminary Part B News analysis.

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.  

Q: If a NPP/PA is supervising a stress test in the hospital and the physician is not on that floor, can the physician bill the 93016 supervision portion of the stress test?

Summary: Some codes seeing the greatest usage growth by non-physician practitioners (NPPs) also see some of the greatest denial rates, an NPP Report analysis shows. The latest 2009 claims data from CMS reveals high denial rates for many common services, which have seen steady growth over the last few years.

Look to electronic health record (EHR) adoption and prevention care measures, such as pneumonia and influenza vaccine administration, when your non-physician practitioners (NPPs) attempt to report Physician Quality Reporting Initiative (PQRI) measures to earn bonuses. An analysis of CMS billing data shows 10 NPP specialties billed quality data codes more than 700,000 times in 2009.

You must review the "incident-to" billing of your non-physician practitioners (NPPs) in general and Part B drugs in particular, or you will risk attracting extra attention from government auditors in 2011, NPP Report has learned. The HHS Office of Inspector General (OIG) plans to examine the billing of Part B drugs that are not typically self-administered by the patient, including the use of incident-to billing by NPPs. 

This week's question is answered by Regan Bode, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q. Patient presents to urgent care or to an instant care provider (ICP). The physician does an X-ray and confirms a fracture, then applies a cast for comfort and refers the patient to orthopedics for permanent treatment. Can the ICP bill for application of the cast or just an E/M code with the codes for casting supplies?

Download the October Tool of the Month, developed by DecisionHealth Professional Services, from the Part B News. This tool will help you establish an office policy for providing medical services to your employees.