Part B Insider (Multispecialty) Coding Alert

Physician Notes:

Congress to Vote on IPAB Repeal

Published on Fri Jun 05, 2015

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Plus: No family history? Explain why.

Most Part B practices have gotten the hang of the Affordable Care Act (ACA) provisions—but one ACA feature could be on its way out the door.

On June 2, the House Ways and Means Committee voted to eliminate the Independent Payment Advisory Board (IPAB) panel. The ACA created the IPAB as a way to pinpoint strategies to save money within the Medicare program, but critics say the IPAB members—chosen by presidential appointment—shouldn’t be making decisions about what type of care Medicare beneficiaries should be receiving. Instead, medical professionals argue, patients and their healthcare teams should be making those determinations.

The bill will hit the floor of the House of Representatives within the next few weeks, and Congress will formally vote on whether to repeal the IPAB. Meanwhile, physician groups are cheering the fact that IPAB could be but a memory soon.

“IPAB is a flawed policy and the AMA has been advocating for the repeal of it since the ACA was passed,” said Robert M. Wah, MD, president of the American Medical Association, in a June 2 statement. “It would put significant health care payment and policy decisions in the hands of an independent body of individuals with far too little accountability…Getting rid of IPAB will allow physicians and policymakers to focus on long term efforts to improve care quality, improve health outcomes and make Medicare more sustainable while preserving access to care for seniors now and in the future.”

In other news…

It happens from time to time—you’re filling out a thorough E/M record, but you’re unable to complete the family history section, often because the patient doesn’t know her history. The solution, Part B MACs advise, is to document the fact that you tried to get the information but couldn’t—and record the reason.

“If for some reason you cannot obtain the family history, the documentation must support the reason why (e.g., the patient was adopted,” says Part B MAC Palmetto GBA in its “Frequently Asked Questions” page.

You should not write “noncontributory, unremarkable or negative” in the family history section, because that does not help an auditor understand what was addressed or even which questions you asked the patient, Palmetto says.

Resource: For more on this topic, visit www.palmettogba.com/palmetto/providers.nsf/DocsCat/Jurisdiction-11-Part-B~8EEM6K6862.