MEDAC BILLING & COMPLIANCE ALERT
February 2, 2010

By: Bellinger P. Moody RHIA,CPC, CCP
Executive Vice President of Compliance

ASA Confers with CMS on New Interpretive Guidelines

In a recent letter to CMS dated January 18, 2010, Dr. Alexander Hannenberg, President of the ASA, stated the ASA’s concerns and perspective in reference to the new revisions to the hospital interpretive guidelines that will affect anesthesia service provision.

MEDAC BILLING & COMPLIANCE ALERT
December 30, 2009

By: Bellinger P. Moody RHIA,CPC, CCP
Executive Vice President of Compliance

New Facet  Injection Codes:  Base Unit Assignments

As you may or may not know, there are new CPT codes for facet injections.  The old codes were 64470, 64472 (Cervical or Thoracic) and 64475, 64475 (Lumbar or Sacral).  The base unit assignments for these codes previously were:

MEDAC BILLING & COMPLIANCE ALERT
November 25, 2009

By: Bellinger P. Moody RHIA,CPC, CCP
Executive Vice President of Compliance

New PQRI Measure in 2010 for Anesthesia

As part of the final rule, CMS has approved another quality measure for anesthesia reporting in 2010.  You will be able to report on a third measure:  Perioperative Temperature Management.   Currently there are two reportable measures for anesthesia:  (1) Measure #30 – Administration of prophylactic antibiotics; and (2) Measure #76 – Central Line Sterile Technique measure.

MEDAC BILLING & COMPLIANCE ALERT
November 24, 2009

By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

New 2010 CPT Codes for Facet Blocks

The old Facet injection block codes, 64470-64476, have been deleted and replaced by codes 64490-64495. Now, there are 6 facet block codes, instead of four.  Additionally, fluoroscopy is now bundled into these codes for all payers. Consequently, the Facet Radiofrequency codes (64622, 64623, 64626, and 64627) have not changed. Therefore, fluoroscopy can still be billed with the facet Radiofrequency codes, and the number of levels of RF has not been restricted, as is the case with the new 2010 facet block codes.

MEDAC BILLING & COMPLIANCE ALERT
November 18, 2009

By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

Clarification & Update:  2010 SRNA Medical Direction Rule

On November 9, 2009 I issued a “Medac Billing & Compliance Alert” entitled “New Teaching Rules for Anesthesiologists”.  In this alert I addressed my interpretation of the 2010 Medicare Physician Fee Schedule Final rule as it pertains to rules for teaching anesthesiologists in reference to Residents and SRNAs. 

As you may or may not know, there has been a great deal of discussion (and alarm) about the “CORRECT” interpretation of the 2010 SRNA teaching rule.  Currently, the anesthesia administrative community is split in its interpretation of the 2010 SRNA teaching rule:

MEDAC HEALTHCARE REFORM ALERT & UPDATE
November 11, 2009

By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

ASA Tele-Town Hall:  Wednesday, November 11, 7pm EST

I strongly urge all Medac Clients that are ASA members to participate in a Tele-Town Hall meeting to be held tonight at 7pm EST.  The Tele-Town Hall meeting will be hosted by ASA President Alex Hannenberg, M.D.  This meeting will focus on the recent bill -- H.R. 3962 “Affordable Health Care for America Act” – and will provide great insight into the history of  the healthcare reform debate and what you must do as the legislative process moves into the U.S Senate and House-Senate conference committee.  

This event is open to all ASA members and Component Society staff and it will provide detailed information and legislative analysis based on the facts relative to healthcare reform.  It is sure to clear up a lot of speculation about what is currently happening and what may happen with healthcare reform.  I encourage all of you to become informed about the provisions included in H.R. 3962 and its effects on the specialty of Anesthesia.  This meeting will also help you to better understand the ASA’s strategy throughout the legislative process.

There are H.R. 3962 materials on the ASA website at www.ASAhq.org that you may review prior to the Tele-Town Hall meeting tonight.  You may register for the Tele-Town Hall meeting online at www.directeventreg.com/registration/event/41033095 or by phone:  (888) 869-1189, Conference ID 41033095.

The information presented herein reflects general information that is current as of the date it is first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information and any general advice previously published might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.

MEDAC BILLING & COMPLIANCE ALERT
November 9, 2009

New Teaching Rules for Anesthesiologists
By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

The 2010 Medicare Physician Fee Schedule Final Rule has new rules for teaching anesthesiologists in reference to residents and SRNA’s.  I will address both rules and the impact they may potentially have on your anesthesia practice.

MEDAC BILLING & COMPLIANCE ALERT
November 6, 2009

CMS Eliminates Consults
By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

For decades, coding professionals and consultants alike have tried to educate physicians about the proper use of the consult codes.  The fact is, many healthcare providers, across all specialties have not properly utilized these codes and as a result, they have been a significant cost burden for CMS.  As reported on Wednesday, November 4 in the MGMA Washington Connection, in an effort to curtail its cost, “in the 2010 Medicare Physician Fee Schedule, CMS has eliminated the use of all consultation codes (inpatient and office/outpatient codes for various places of service except for tele-health consultation G-codes)”.  

In an effort to calm providers on the elimination of consults, CMS has increased the work RVUs for new and established patient visits.  They have also increased the work RVUs on initial hospital and nursing facility visits, and have made adjustments for the increased use of these codes into the practice expense and malpractice RVU calculations.

Will this decrease your revenues?

MEDAC BILLING & COMPLIANCE ALERT
November 2, 2009

Red Flags Rule Delayed Once Again

By: Bellinger P. Moody, RHIA, CPC, CCP,
Executive Vice President of Compliance

According to a recent posting on the Federal Trade Commission’s website:  www.ftc.gov/opa/2009/10/redflags.shtm, at the request of Members of Congress, enforcement of the Red Flags Rule has been delayed again – this time until June 1, 2010. 

The delay was posted on the FTC site on Friday, October 30, 2009 at approximately 3:37 pm.  Therefore, those physician practices with greater than 20 members now have until June 1, 2010 to fully develop and implement identity theft prevention programs.

The information presented herein reflects general information that is current as of the date it is first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information and any general advice previously published might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.

MEDAC BILLING & COMPLIANCE ALERT
October 30, 2009

By: Bellinger P. Moody, RHIA, CPC, CPC-I, CCP
Executive Vice President of Compliance

Red Flag Identity Theft Rules

Effective November 1, 2009, the FTC mandated Red Flag Rules for health care providers become enforceable.

In compliance with these rules, Medac, Inc. has adopted new policies and procedures to identify and avoid risk factors in patient accounts.  One significant risk factor is patient identity theft – specifically in the processing of patient credit card information.

MEDAC BILLING & COMPLIANCE ALERT
October 23, 2009

By Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

NC Medicare Bundles Fluoroscopy Service With Facet Joint Injections/Denervations & SI Joint Injections:  Other Medicare Contractors Likely To Follow

Effective for dates of service performed on or after September 15, 2009, NC Medicare will no longer separately pay for Fluoroscopy (CPT code 77003-26) when performed in addition to Paravertebral Facet Joint Nerve Blocks/Denervation and Sacroiliac Joint Injections.

MEDAC BILLING & COMPLIANCE ALERT
PA Catheter Rebill Potential for Additional Revenues

By: Bellinger P. Moody, RHIA, CPC, CCP
Executive Vice President of Compliance

Due to a recent increase in the Practice Expense Relative Value Units (PE RVUs) assigned to CPT code 93503 -- Insertion and placement of flow directed catheter (e.g., Swan-Ganz) -- when performed in the facility setting, you may be able to get additional reimbursement for all PA catheters billed in the facility setting, effective October 5, 2009.