From the Field: Revalidate or Risk Losing Your Program

Rick Collins Can you, your practice, or facility afford to lose weeks or possibly months of Medicare reimbursement? If not, pay close attention to the new round of CMS Provider Enrollment Revalidations that will be coming your way. Failing to respond quickly to the new Revalidation Cycle 2 notices will result in the deactivation of your Medicare provider number. Unlike ... Read More »

From the Field: Medicare Capitated Payment Q&A Part Two

Rick Collins In the last issue, we answered questions regarding basic tenets of the Medicare Monthly Capitated Payment (MCP) for nephrologists and their associated practitioners. In this issue we will wrap up our review of the MCP and related regulations by looking at possible exemptions for the face-to-face visit requirement and billing for services provided to an ESRD patient for ... Read More »

From the Editorial Board: Hyperkalemia—The Bane of Our Existence

Kenneth A. Liss, DO Hypertension & Nephrology Associates Eatontown, New Jersey The great existential question that all nephrologists learn early in their career is… “What is the potassium?” For years, medical residents, RNs, and emergency department personnel have heard this frequent inquiry. If the level is acceptable, we can probably go back to sleep and address the problem the next ... Read More »

From the Chair: Treatment of Moderately Severe IgA Nephropathy

Ajay K Singh, MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts D’Amico, in a classic paper published in 19871, labeled IgA nephropathy as the “commonest glomerulonephritis in the world.” This may be true in some parts of the world, such as Southeast Asia, but in North America the prevalence is reported to be about 10%, ... Read More »

From the Field: Medicare Monthly Capitation Payment Q & A (Part One)

Rick Collins Now that we have survived the implementation of ICD-10, our focus for this issue and the next turns to the Medicare Monthly Capitation Payment (MCP). The increase in the use of physician assistants (PAs) and nurse practitioners (NPs), along with the implementation of telehealth are two areas that typically generate many questions related to the MCP. In this ... Read More »

From the Field: New Payment Adjustments; Initial ICD-10 Claims Processing

Rick Collins It was a victory for the little guys when the 2016 Centers for Medicare & Medicaid Services (CMS) ESRD PPS (Bundle) Final Rule was released at the end of October. Rural dialysis facilities, regardless of size, will receive a new payment adjustment of 0.8%. Small dialysis facilities will benefit from the 26% increase in the Low Volume Payment ... Read More »

From the Chair: Tolvaptan for Treatment of ADPKD

Ajay K. Singh MBBS, FRCP, MBA Brigham and Women’s Hospital and Harvard Medical School Boston, Massachusetts ADPKD still has no cure. However, 3 years back, reviewing the key results [see sidebar] of the pivotal TEMPO 3:4 trial published by Torres and colleagues in the New England Journal of Medicine2, the FDA declined to approve tolvaptan as a treatment to slow ... Read More »

From the Field: Composite vs Bundle Confusion

Rick Collins I knew it was going to happen. When the CMS ESRD PPS (Bundle) was introduced for 2011, CMS kept all of the terminology, rules, and regulations that existed prior to the Bundle. While that was a great way for billers to transition to the Bundle in 2011, keeping the old rules has become increasingly confusing for those new ... Read More »

From the Editor: Referring a Patient for Kidney Transplant Needs Improvement

Ajay K. Singh A recent paper published by Patzar and colleagues from Emory in JAMA1 reveals a low rate and marked variability in kidney transplant referrals within the state of Georgia. Once referred, only a fraction of patients actually get listed. Georgia has the lowest rate of transplantation in the United States at approximately 25%. Prior research might have explained ... Read More »

From the Field: Rick Collins

“LOW COST” BILLING COMPANIES CAN COST YOU A LOT My phone has been ringing more lately as nephrologists contact me about providing billing services in light of the imminent implementation of ICD-10. We normally have a good chat as they recognize that our services are tailored specifically for those in the renal industry. However, unlike in the past, our good ... Read More »