You now face restrictions on separate billing of facet joint injections and telehealth visits alongside a wide array of surgery codes, according to a Part B News analysis of the latest version of the Correct Coding Initiative (CCI) edits, which took effect July 1. There are 16,928 changes, almost all of which are new edit pairs. For comparison, that's eight times the number of changes in the previous CCI version, which had just 2,195 changes (PBN 3/29/10).

Congress finally passed a Medicare payment patch to delay the devastating 21.3% cut to your reimbursements for six months and replace it with a 2.2% increase retroactive to June 1. CMS has yet to announce how it will reprocess your June claims paid at a reduced rate, but the HHS Office of Inspector General (OIG) says you will not need to collect any additional amounts from patients who received care from you between June 1 and June 25, which is the date the pay fix was signed into law.

Your claims will not be automatically rejected on July 6 when they contain orders or referrals from providers not properly enrolled in CMS's Provider Enrollment, Chain and Ownership System (PECOS), the agency announced June 30.

The proposed 2011 Medicare Physician Fee Schedule (PFS) is pulling double-duty, packed with expansions of existing CMS initiatives plus major Medicare changes mandated by the health reform law. The law's emphasis on preventive medicine is taking the form of major benefits for primary care, starting with a new, routine service billable once a year for all beneficiaries, free of copays and deductibles, plus new coverage for more than 30 preventive services.

CMS has released its proposed 2011 Medicare Physician Fee Schedule on June 25, late in the afternoon, a full day after the current issue of Part B News went to press. The proposed rule is packed with good news for primary care practices, a preliminary Part B News analysis shows. Here's the goods on two of the biggest bombshells in the rule. 

Legislators in the House and Senate finally came together late on June 24 to pass legislation to delay the 21.3% cut to your payments until Nov. 30. The legislation actually boosts your pay by 2.2% retroactive to June 1.

You've now got the standards your electronic health record (EHR) system will need to meet to be certified, as HHS published a final rule June 18. This rule sets the stage for the pending release of the long-awaited meaningful use final rule that will show you how to earn up to $44,000 in federal health information technology (HIT) incentives.

Start preparing now for HIPAA and ICD-10 transitions if you haven't done so already, top CMS officials reminded physician practices on June 15. These transitions - to the HIPAA 5010 standard for electronic claims transfers in 2012 and to the ICD-10 diagnosis code set in 2013 - seem far away, but you need to take advantage of the lead time to avoid major A/R disruptions and ensure your claims will get paid properly on day one.

Overall drug prices on the Part B Average Sales Price (ASP) list will tumble next quarter, CMS says. Prices will decrease by 0.7% despite a Part B News analysis of the ASP plus 6% payment system that shows a majority of the individual drugs will see price increases. The introduction of generics caused some drug prices to drop by 20% or more and brought down the rest of the list, CMS says.

Last week, Part B News detailed electronic health record (EHR) facts you must know before purchasing a system for your practice - setting you on a path toward earning $44,000 in federal incentives (PBN 6/21/10). You must also be aware of hidden or unexpected costs associated with these major purchases - which can send your EHR costs spiraling over budget.