Part B Insider (Multispecialty) Coding Alert

Plus, HHS moves to stop the overprescribing of opioids.

The Medicare Learning Network (MLN) focuses on chiropractic services this week in its inaugural edition of a new section devoted to compliance and claims issues.

The section hopes to assist providers with issues they may have over particular codes, claims, and services. With resources and documents dedicated to the week’s topic and specialty, MLN advises providers on ways to avoid denials and the pitfalls some services and claims pose.

For example, MLN explains that 51.7 percent of chiropractic claims are improperly billed. “The most common reason for the improper payments is insufficient documentation to support the billed services,” the July 14, 2016 MLN release states.

Check in each week with MLN E-News to see if your specialty’s billing issues are highlighted.

Resource: For more information about this new MLN section, visit https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Partnership-Email-Archive-Items/2016-07-14-eNews.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending#Provider Compliance.

In other news…

Despite the HHS Opioid Initiative that began in March 2015, opioid abuse and over-prescription remain a serious problem for the nation’s health providers, regulators, and politicians. Now, it appears that CMS is poised to help quell the problem.

“Many clinicians report feeling pressure to overprescribe opioids because scores on the HCAHPS survey pain management questions are tied to Medicare payments to hospitals,” an HHS July 6, 2016 press release states.

CMS plans to eliminate the questions for future payment calculations. While the hospitals would not stop asking the questions, they would no longer determine the level of payment each hospital receives from them.

Resource: For a complete transcript of the July 6, 2016 HHS press release, visit: http://www.hhs.gov/about/news/2016/07/06/hhs-announces-new-actions-combat-opioid-epidemic.html.

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