Ongoing health reform efforts in Congress should dominate your attention span because it promises to bring profound change to your practice. You're also concerned with last-ditch efforts to fix the more than 21% cut to Medicare payments staring you in the face. But these are not the only things you need to be aware of to bill successfully in 2010.

For many high-utilization codes, it's deletions in the latest set of Correct Coding Initiative (CCI) edits that have the most impact, according to a Part B News analysis of CMS claims data from 2008 and changes in CCI version 16.0, in effect since Jan. 1 (PBN 12/21/09).

CMS will ring in the New Year with a temporary payment hold on your claims. According to a CMS list-serve notice issued Dec. 21, carriers will hold claims for ten business days (Jan. 1 to Jan. 15, 2010). CMS is taking this step to avoid the confusion that has resulted when Congress passed a pay fix soon after the start of the year and carriers had to reprocess all of the claims that were submitted in the interim.

There's good news and bad news for your drug billing as 2010 kicks off. Aggregate payments for the top 50 drugs billed to Medicare are expected to dip by 1.1%, although more individual drug codes will see boosts than cuts in the first quarter of 2010 under Medicare's average sales price (ASP) +6% payment system.

When we submit a claim with modifier 53 (discontinued procedure), our carrier holds our payment until we provide additional information on why the procedure was discontinued. According to the carrier, we can put the information in Box 19 on the claim form to avoid the delay. My question is, what information should I include that will satisfy the carrier, avoid a delay and fit within the space allotted for that box?

You'll get the chance to transform the way your practice runs in the next five years, thanks to $34 billion in Medicare incentive funds for "meaningful use" of electronic health record (EHR) systems starting in 2015, coupled with government plans to impose heavy fines when you fail to achieve meaningful use or stick with paper records.

Adopting an EHR alone is a massive and costly undertaking. But some experts believe you'll also need an online patient portal - a suite of Internet-based software that connects your records to your patients - to achieve meaningful use.

Unfortunately, patient portals are almost always sold separately from EHRs, leaving you and most of your peers, who have neither an EHR nor a patient portal, with a huge decision on which component to implement first and precious little time to decide.

You now have a game plan for successfully billing initial E/M visits in hospitals or nursing facilities when your physician is the admitting physician and other providers are also billing initial inpatient codes for the patient's care, a scenario that becomes possible after Medicare consult billing is eliminated Jan. 1.

The House of Representatives approved a defense appropriations bill that includes a two-month delay to the 21.29% pay cut now scheduled to hit your payments on Jan. 1. What do your Medicare payments have to do with Department of Defense spending? Nothing. The bill, which passed on Dec. 16, was a "vehicle" for lawmakers to attach the amendment. It now needs to pass the Senate before going on for the president's signature.

Don't assume a quality measure you previously reported has not changed. Something in most measures has changed from 2008 and 2009 reporting periods, a consultant tells Part B News.

After telling Part B News they were considering quality reporting in August, administrators at a 22-physician, multispecialty group realized the practice could meet reporting requirements not just in 2010 but in 2009, too - potentially yielding as much as $15,000 in yearly incentive bonuses from just five of its internal medicine physicians.