Summary: This chart shows the volume of Medicare claims billed by the highest and lowest physician specialties, defined by the average number of claims billed. Example: The average infectious disease specialist billed 10,602 services to Medicare in 2009, compared to an average of 862 services billed to Medicare by general practitioners in the same year.

The NPP Report is free to Part B News readers as part of the newsletter subscription. The October issue analyzes how NPPs are reporting quality of care codes to earn bonuses from CMS, NPP targets in the latest Office of Inspector General (OIG) Work Plan and 10 high-growth, high-denial services provided by NPPs in 2009.

Bill the unlisted special service code (99199, carrier priced) when you provide a smoking cessation service to patients who don't present with signs or symptoms of a tobacco-related disease, CMS says. CMS changed its coverage policy for the cessation services on Aug. 25, but doesn't want you to bill existing codes for it.

Physicians from around the country have told CMS they will stop treating Medicare patients if a 23% cut hits their reimbursements on Dec. 1. The 2011 Medicare Physician Fee Schedule will be finalized by Nov. 1 and the 2011 conversion factor will reflect the 23% cut and another 6% reduction scheduled for Jan. 1.

You'll face a wide-ranging series of changes to surgery coding under CPT 2011, an exclusive Part B News analysis shows. These changes bundle previously separate codes into one code and are likely to reduce payments for cardiologists, orthopedic surgeons, general surgeons and neurosurgeons, experts believe.

You'll find three new E/M codes in your 2011 CPT book, along with significant bundling of surgical codes likely to negatively impact cardiology and surgery practices, experts tell Part B News. Some codes, new and revised, appear out of sequence, a tactic the AMA began in the 2010 CPT book. The three new E/M codes, for "subsequent observation care," are resequenced.

Your doctors might think documentation shortcuts save time and boost efficiency, but they could also raise your practice's audit risk when government inspectors come knocking, experts tell Part B News. E/M documentation that looks similar or identical for different patient encounters will be scrutinized by the HHS Office of Inspector General (OIG) starting next year.

Remember to update your enrollment records when a physician or non-physician practitioner (NPP) leaves your group to protect your practice against possible fraud or false accusations of improper billing. The provider's National Provider Identifier (NPI) number will still be attached to your group's Provider Transaction Account Number (PTAN).

You still have time to earn 2010 bonuses under CMS's E-prescribing Incentive Program. Qualifying for the bonus before 2010 ends could mean an extra $2,612 for every physician or non-physician practitioner (NPP) at your practice. That's the average amount your peers earned in 2009, according to CMS statistics.

I have a two doctor OB/GYN clinic that also performs GYN surgery. If the patient needs a hysterectomy (58270) and urinary suspension (sling) repair (57288), one doctor will do the hysterectomy and the other will assist him. Then the other doctor will do the sling with the first doctor assisting. Both doctors are able to do both surgeries, but they split this up to gain more reimbursement (around $350.00). Is this compliant? We're getting paid by Medicare and other payers, but I feel that it is wrong.