Check your mail and your bank account: Physician Quality Reporting Initiative (PQRI) bonus checks for 2008 have started to arrive. You may find some of the same troubles from last year when you try to access your PQRI feedback report to determine which doctors successfully earned the bonus.

You and your peers left millions of dollars behind in 2008, thanks to staggering denial rates on four commonly billed allergy testing services, a Part B News analysis shows (see chart, below). The rising denials for 95004 and 95024 are especially troubling, since they make up the bread-and-butter of testing payments for allergy practices, experts say.

One positive result should you lose the ability to bill consultations is that you won't have to follow the rigid documentation rules for the service any more. Keep in mind: CMS has not confirmed it would eliminate consults, but the agency could do so in the 2010 Medicare Physician Fee Schedule later this month (PBN 8/24/09).

Imaging utilization by primary care practices has been falling over the last three years, according to a Part B News analysis of the latest CMS claims data. The chart below shows a specialty-by-specialty breakdown of imaging utilization in 2006 and 2008.

Go straight to your carrier's local coverage determinations (LCDs) or CMS's national coverage determinations (NCDs) when you receive a denial stating a claim lacked medical necessity.

When your providers order supplies or medical equipment, CMS will deny the claim automatically if their enrollment information isn't in its online Provider Enrollment Chain Ownership System (PECOS). This strict new rule goes into effect Jan. 1, 2010 - right now you just get a warning (see story).

I'm billing for a doctor who works in an independent, free-standing urgent care center (POS 20) and I'm not sure which E/M codes I should use. The facility is open 24/7 so it's more like an emergency room. Do I have to use the usual office visit codes? If so, will I need to track each patient's visit and then bill the established patient codes if he/she comes back within the three-year period?

Increase your reimbursements for non-physician practitioners (NPPs) by getting them involved in reporting Physician Quality Reporting Initiative (PQRI) and electronic prescribing programs. It's not just physicians who are eligible for bonus payments.

Non-physician practitioners (NPPs) are seeing a high denial rate on low-level E/M codes, according to an NPP Report analysis of the latest CMS claims data. 99212 (office/outpatient visit, est., $37.15) was denied an astounding 20.2% of the time in 2008 - that's more than one denial for every five claims submitted. 99211 (office/outpatient visit, est., $18.75) had a 40.6% denial rate in 2008.

Physical therapy and chiropractic manipulation codes remain the fastest-growing but most often denied services for non-physician practitioners (NPPs), according to an NPP Report analysis of the latest CMS claims data.