Practice Management

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In the new millennium, we are confronted with rising overhead and decreasing reimbursements, which translates into loss of income. Many will try to recapture this loss by increasing patient volume.

The American Medical Association has developed a kit that provides physicians and their office staff with a step-by-step approach to uncovering and appealing claims that have been inappropriately denied or underpaid by health plans.

Las Vegas--The Centers for Medicare & Medicaid Services istaking steps to lessen the burden that its policies create for physicians,according to two West Coast representatives of the agency. Physicians alsohave more influence on shaping health care policy, including the value ofservices, than they realize, said the officials, both physicians themselves.

The Centers for Medicare & Medicaid Services has adopted the National Provider Identifier (NPI) as the standard unique health identifier for health care providers to use in filing and processing health care claims and other transactions.

Q I am in a multiple-physician urology practice. One of our physiciansbelieves that billing 52332 with 52352 or 52353 with a ­59 modifiershould be paid, and that billing 52005 with 52332 with the ­59 modifiershould be paid (ie, 52005-59). When is it appropriate to use the ­59modifier?

The American Medical Association has issued a temporary code for reimbursement of online consultations between physicians and patients, Health Data Management reports.

Washington--The new Medicare reform bill, which for the first time providesa prescription drug benefit for Medicare recipients, comes with a hiddencost for physicians who administer chemotherapy drugs in their offices-andperhaps their patients.

Minneapolis--Surgeons and other physicians across the country continueto deal with the higher costs of practicing medicine in the face of decliningreimbursements. Those factors added up to lower profit margins for U.S.physician groups in 2002 and a continuing awareness of the need to pay attentionto all of the vagaries of the business of practicing medicine. For the mostpart, urologists showed little change in reimbursement.

San Jose, CA?The Centers for Medicare and Medicaid Services has approved an application for assigning a new technology Ambulatory Payment Classification for photoselective vaporization of the prostate (PVP) to treat BPH.

The Centers for Medicare & Medicaid Services said it has updatedand improved its process for making Medicare coverage decisions. A noticepublished in the Federal Register on Sept. 26 incorporates lessons learnedover the past 3 years and implements certain requirements of the Medicare,Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000.

Many U.S. physician groups are experiencing losses in the midst of anincreasingly competitive and regulatory environment, according to a recentsurvey by the American Medical Group Association. Results for medical groupfinancial performance on a per-physician basis revealed that the averagegroup lost $3,977 per physician.

Also, advice on billing for marker seeds and national figures for E&MservicesQ I work for two urologists. We have changed our schedule so thatone physician is always in the office when we administer leuprolide acetateinjections and perform uroflows, catheterizations, and other procedures.Who should charge for the service?