Make sure your ultrasound billing is solid after the latest HHS Office of Inspector General (OIG) audit. Expect CMS to take more aggressive steps to detect questionable claims and high utilization of ultrasound services, the OIG says.

Bring your providers and office staff to the table when deciding which Physician Quality Reporting Initiative (PQRI) measures you'll report next year, providers say. There are three basic questions you need to have answered before going forward.

You are equally likely to see a demand letter from a recovery audit contractor (RAC) for seven recently announced audit targets regardless of your practice size, experts say. Florida practices were the latest to become eligible for RAC review; the state was added to Connolly Healthcare's website on Aug. 18. Take proactive measures now to be ready in case demand letters for any of the approved targets show up (see story, here).

You're looking down the barrel of the first seven, real recovery audit contractor (RAC) targets, but there's no reason to be afraid, experts tell Part B News. Minimize your chances of being audited by taking a few proactive steps, says Stacy Levitt, director of patient care management at Lenox Hill Hospital in New York.

Show your providers these new instructions for billing facet joint injections from CMS. The injection codes have led to millions of dollars in improper payments and triggered denial rates above 20% per year. The guidance comes from Transmittal 526, a one-time notification effective Aug. 31.

Senate lawmakers have yet to agree on legislation to avoid the 21.5% cut to your Medicare payments set for 2010 as public debate rages over other health reform initiatives such as end-of-life planning and creating another public health insurance option.

This chart shows 10 specialties with the highest growth in median physician compensation from 2004 to 2008, based on survey data from the Medical Group Management Association (MGMA). Overall, the best-paid specialties in this list tended to make greater gains than those less paid.

Can a specialist called in to the emergency department (ED) bill codes 99281-99285 (emergency department visit, $20.20-$170.23)? I've heard those codes are reserved for the ED physician.

You and your peers are billing more physical therapy (PT) services to Medicare than ever before, and the denial rate has gone up right alongside in the last few years, according to an NPP Report analysis. The two most commonly billed codes, 97110 and 97140, were billed 43 million times in 2007, up 14% from 37.7 million times in 2005. Over the same period, their denial rates jumped into double digits (see sidebar, here).

Physical therapy (PT) services are among the fastest-growing in terms of Medicare utilization for a variety of reasons (see story, here). Unfortunately, denials have gone up just as quickly, according to an NPP Report analysis.