You will see a wave of surgery code pair changes in 2012’s first batch of revisions to the Correct Coding Initiative (CCI) edits, version 18.0, which took effect Jan. 1. There are a total of 21,727 changes, nearly 10 times the 2,271 changes from version 17.3 of 2011’s fourth quarter, an exclusive Part B News analysis shows.

Heard the one about the three-month-old baby that failed her family physician’s “oriented x3” test? That is, her physician’s computer-generated exam notes showed the newborn was unable to state her name or answer other key questions doctors generally use to test mental acuity in elderly patients.

You must have a plan for handling limited English proficiency (LEP) patients because you’re responsible for providing and paying for translation services to patients, who do not speak, read or write English well. Preparing for LEP patients as well as those with special needs, such as blindness, is something that many practices don’t plan for, says Ken Hertz, principal consultant with the MGMA Healthcare Consulting Group in Alexandria, La.

 CMS holding all 2012 claims for 10 days. You will not get paid for claims submitted after Jan. 1 until Jan. 18 at the latest. CMS is holding all claims with a date of service of Jan. 1 or later for up to 10 business days in order to test and implement the 2012 Medicare Physician Fee Schedule, CMS announced in an MLN Matters article.

This is a table reflecting some of the major changes from selected chapters that were made to the CCI policy manual, version17.3. TIP: You can download the full three-page analysis by clicking the "Download File" link at the top of the story.

This chart shows the 10 specialties that saw the greatest growth in per-physician median compensation from 2009 to 2010, based on data published in the Medical Group Management Association’s (MGMA) 2011 Physician Compensation and Production Survey. NOTE: The following physician types in the graph below represent combined specialties: Internal medicine, cardiology (invasive), dermatology, hematology/oncology, orthopedic surgery and psychiatry. 

If a patient is getting a colonoscopy for a V12.72 history of colon polyps with no other indications, does CMS consider that to be G0105 (colorectal cancer screening) or 45378 (diagnostic colonoscopy)?  The physicians refer to it as “surveillance” and bill 45378 - V12.72. Medicare pays but we need clarity on what is considered correct.

This table is not only easy on the eyes but chock full of good coding info. December's Tool of the Month belongs to version 17.3 of the CCI policy manual. The new manual debuted Dec. 1 but does not take effect until Jan. 1, 2012 (just in time for the 2012's first quarter round of CCI edits, see related story here). You'll find this table to be a quick guide highlighting the manual's biggest changes selected chapters to match up with the new CCI edits.