General Surgery Coding Alert - 2016 Issue 6
Part B Carriers: Yes, You Can Choose to Limit New Medicare Patients
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Article Overview
This article reviews practical guidance shared by Medicare Part B contractors and MAC representatives on common billing and practice-management questions. It is aimed at providers and billing staff who need to understand how local Medicare payer interpretations affect patient acceptance policies, wellness visit reporting, and incident-to service supervision. The piece also highlights related documentation and supervision topics that practices should verify against their own MAC and state licensure rules.
Why This Topic Matters
Medicare rules can vary in how contractors explain and operationalize them, so practices need current carrier guidance to avoid billing errors and compliance problems. This article helps readers identify which operational questions are addressed by MAC education and contractor Q&A sessions.
Article Sections
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Contract With Medicare? You Can Still Limit New Medicare Patients
Discusses provider choice in accepting new Medicare patients and the practical implications for ongoing billing obligations once a patient is established.
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Individual Payers Can Decide Who Performs AWVs
Covers contractor guidance on annual wellness visits, including who may participate in service documentation and the circumstances that affect reporting alongside another evaluation service.
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Be Within ‘Speaking Loudly Distance’ for Incident to Services
Reviews incident-to supervision concepts, personnel relationships, and situations that can affect whether services remain within the intended billing framework.
What You Will Learn
- How Medicare contractor guidance addresses limiting acceptance of new patients.
- What contractor education says about roles in annual wellness visit services.
- Which supervision and workflow topics are discussed for incident-to services.
- What types of documentation and billing considerations are raised in MAC question-and-answer sessions.
Who Should Read This
- Physicians
- Nurse practitioners
- Practice managers
- Medical coders
- Billing staff
- Compliance staff
Codes Discussed
Modifiers Discussed
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