You need to actively monitor key performance data and respond accordingly - if you want to do more than just scrape through the economic hurricane, experts say. Most practices know when they're losing money, but there's more to running a business than just knowing when you're in the red, says Larry Gold, a practice management expert with DecisionHealth Consulting Services. "Doctors tend to make emotional decisions," Gold says. "But you need to look at the data on a weekly basis, then ask yourself dispassionately, ‘what's changed and what do I about it?'" 

Meaningful use of electronic health records (EHRs) is one obstacle that will stand between you and up to $44,000 per provider in incentives for adopting health information technology (HIT) at your practice (PBN 2/23/09). This year's stimulus bill, the American Recovery and Reinvestment Act, gives you some idea of what "meaningful use" is, but the full definition has yet to be articulated by CMS - the agency likely to administer the HIT incentive program beginning in 2011.

CMS will use the most favorable outcome of two calculations for providers reporting the Physician Quality Reporting Initiative (PQRI) fluoroscopic measure that erroneously contains 22 CPT codes for non-fluoroscopic procedures (PBN 3/30/09). 

Physicians and non-physician practitioners (NPPs) are exempt from purchasing surety bonds in order to provide durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), CMS says.

Practices that use NPPs to administer trigger point injections need to sharpen their coding if they want to avoid the high denial rates for this service. 

This week's question is answered by John Bishop CPC, PA-C, Senior Consultant for DecisionHealth Professional Services.

Q. We keep getting denials when two providers perform 90801 (mental health initial evaluation, $152.92) for the same patient. One provider provides therapy and the other manages the patient's medication. The assessments are different for each provider. Medicare denies the second claim and states this is "too many services." Can you shed any light on why we're getting the second denial?