Part B News

MACs warn of 4 billing company behaviors that could harm your practice

By: Julia Kyles, CPC

Hiring the right third-party billing company can improve your revenue and reduce compliance headaches for your practice. Hiring the wrong company can mean your practice is responsible for behavior that aggravates your Medicare administrative contractor (MAC), could result in negative consequences for your practice, and the billing company might even charge you extra for the problems it is creating.

QPP reports show MIPS fading as groups pivot to APM models

The latest CMS reports on the Quality Payment Program (QPP) suggest that participation in the Merit-based Incentive Payment System (MIPS), while still favored by most participants, is declining as participation in the Advanced Alternative Payment Model (Advanced APM) path grows.

Part II: Expert Q&A covers NIST Cybersecurity Resource Guide

By: Dom Nicastro

The National Institute of Standards and Technology (NIST) published NIST SP 800-66 Rev. 2 in February. You can turn to the publication to gain practical guidance and to safeguard health information and better understand the security concepts discussed in the HIPAA Security Rule including for business associates (BA) and covered entities (CE). The Q&A continues below.

Ask a Part B News Expert

Question: Do you have any advice for encouraging providers to improve documentation for wound sizing in CPT?... More

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Nearly 60% of small practices used the group reporting option to participate in the 2022 Quality Payment Program (QPP), and nearly 45% of small practices that participated via group reporting received... More

Ask a Part B News Expert

Question: Do you have any advice for encouraging providers to improve documentation for wound sizing in CPT?... More

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Nearly 60% of small practices used the group reporting option to participate in the 2022 Quality Payment Program (QPP), and nearly 45% of small practices that participated via group reporting received... More

Expert: SDOH assessment needs follow-through beyond documentation

Legal expert gets specific on exemptions to the FTC’s noncompete rule

After FTC rule bans noncompetes, legal expert discusses impact on health care

Give providers an illustrated guide to the new SDOH risk assessment code

Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).

Cultivate Medicare prolonged service rule compliance with a decision tree

Use this decision tree to illustrate Medicare’s rules for coding prolonged E/M services. Medicare created codes and rules for prolonged services performed by a physician or qualified health care professional (QHP) because it disagrees with portions of the CPT guidelines.

QPP 2022: Clinicians at small practices preferred group reporting

Nearly 60% of small practices used the group reporting option to participate in the 2022 Quality Payment Program (QPP), and nearly 45% of small practices that participated via group reporting received the small practice bonus, according to Part B News analysis of the 2022 QPP Public Use File (PUF), which contains the most recent data on QPP participation.

G0136 joins select group of codes cleared for use with modifier 33

A new billing policy requires that modifier 33 (Preventive services) appear with the social determinants of health (SDOH) assessment add-on code G0136 on all such claims submitted with annual wellness visits (AWV). This will mean a big change in that modifier’s utilization, which has mainly been limited to four codes (and overwhelmingly used for just one).

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Advanced Specialty Coding Virtual Summit: Orthopedics

VIRTUAL

Advanced Specialty Coding Virtual Summit: Pain Management

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