Part B News | Part B News

Modifier 25 stays down in ’21, yet practices reap fee gains

03/20/2023

Medical groups posted some big numbers in their use of modifier 25 (Significant, separately identifiable E/M service), reporting over 65 million claims and clearing $5 billion in payments in 2021, the latest year of available data. While payments grew, the usage numbers remained down from pre-COVID highs just two years earlier.

The taxman cometh: File wisely, secure the most from practice deductions

03/13/2023

by: Roy Edroso

April is tax time, and practice owners should be attentive to changes in the tax environment — including increased legal and IRS attention and a few wrinkles in the tax code that medical personnel tend to miss.

Fearing ‘telehealth cliff,’ orgs oppose DEA’s proposed time limits, in-person demands

03/13/2023

by: Julia Kyles, CPC

Unnecessary, alarming, a step backwards. These are three terms health care organizations used to describe the Drug Enforcement Administration’s (DEA) plans for telehealth when the COVID-19 public health emergency (PHE) ends.

AMA updates two data definitions, hints at changes in 2024 and beyond

03/13/2023

by: Julia Kyles, CPC

You can assign two data points when a provider orders and interprets a test, and count documents from an appropriate source toward data review. The new guidance applies to medical decision-making (MDM) for all level-based E/M visits. It was issued in the March 1 version of the errata and technical corrections for the 2023 CPT manual and released March 3. The changes are retroactive to Jan. 1.

Psychological, neuropsychological and neurobehavioral status testing codes, 2018 and 2019

03/13/2023

by: Julia Kyles, CPC

Here are the codes and consumer-friendly descriptors featured in the Benchmark of the Week. The list represents the codes that were in effect in 2018 and 2019. It is not a crosswalk.

Major code revisions did not hamper psychological testing

03/13/2023

by: Julia Kyles, CPC

Claims for psychological, neuropsychological and neurobehavioral status testing increased and denials fell after the AMA made major revisions to the code sets in 2019, according to analysis of Medicare Part B data.

Stand by until July for the next update to the NCCI

03/13/2023

by: Julia Kyles, CPC

It’s not an early April Fool’s joke: CMS won’t issue National Correct Coding Initiative (NCCI) edits in April.

CMS publishes FAQ on modifiers JW and JZ

03/13/2023

by: Savannah Schmidt

CMS recently published an FAQ document on the use of drug waste modifiers. The resource addresses how the modifiers affect Medicare policy, to which products they can be appended, billing concerns and more.

Amazon’s primary care splurge signals course change in M&A activity

03/06/2023

by: Roy Edroso

Two recent transactions in the multibillion dollar range suggest a change in direction toward more investment in primary care. While fears of consolidation grow, you may also find good news for physician practice owners who want to sell out but keep some control over the destiny of their patients.

Prepare for change in telehealth and controlled substance Rx after the PHE

03/06/2023

by: Julia Kyles, CPC

Stay on top of a series of proposed rules that will impact waivers for controlled substance prescriptions written during telehealth visits. Federal agencies are sharpening a range of policies in anticipation of the end of the COVID-19 public health emergency (PHE), which expires May 11.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.