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CMS boosts pay for ‘Welcome to Medicare' exam in 2010

12/10/2009

You and your peers will receive more money - nearly the equivalent of your payment for new patient visit 99204 (outpatient/office, new, $141.74) - when your physicians furnish the "Welcome to Medicare" exam to your patients (PBN 11/9/09). The 2010 Medicare Physician Fee Schedule raises payment for the preventive service exam G0402 (Initial Preventive Physical Exam during first 12 months of Medicare enrollment) to $104.76 from $92.69 in 2009. You would receive more than $130 if Congress eliminates a 21.29% cut to Medicare reimbursements set for Jan. 1.

Ask a Part B News Expert

12/10/2009

This week's question is answered by Margie Scalley Vaught, CPC, coding content specialists for DecisionHealth.

Q. What sort of documentation do we need to support vitamin B12 injections?

Benchmark of the Week: High-growth, high-denial drug codes

12/10/2009

Summary: Unspecified drug injections are one of the fastest-growing high-denial drugs commonly billed to Medicare, according to a Part B News analysis of the latest CMS claims data. J3490 (drugs unclassified injection) joins J1562 (Vivaglobin), used for patients with primary immunodeficiency and J0878 (Daptomycin injection), used to fight drug-resistant bacterial infections, in our list of 10 high-growth, high-utilization, high-denial drug codes.

Report new G-code to earn e-prescribing bonus in 2010

12/10/2009

You must use a new G-code to report you've electronically prescribed drugs for a Medicare patient in 2010. You'll forfeit incentive bonuses - amounting to roughly $1,500 per provider - if you continue to report old codes for e-prescribing.

CMS: PC does not stand for ‘professional component'

12/10/2009

Some of your peers are having a little trouble with modifier PC, one of the three modifiers for "never events." The modifier indicates "Wrong Surgery on a Patient," and it will trigger an automatic denial.

Nursing facility guidance, prolonged services top 2010 CPT changes

12/10/2009

Here's a round-up of other HCPCS changes you can expect in 2010 (see related story).

Medical societies seek 30-day delay to SGR cut, then fix in 2010

12/10/2009

Members of Congress could move to delay a 21.29% cut to Medicare payments set for Jan. 1 by just 30 days - buying them time to pass a permanent solution to a flawed pay system after New Year's Day.

The basic elements of the ‘Welcome to Medicare' exam

12/10/2009

Here are the basic elements of the "Welcome to Medicare" exam. Providers who currently render the exam say they've developed checklists and guides to help document the exam. Below, you'll find links to guides to help you complete the exam.

CMS: Consult change is final; new modifier to be released any day

12/10/2009

Pay no mind to rumors CMS will delay or even cancel its plan to eliminate consults. Not only is the change permanent, but CMS says it is days away from releasing the new modifier that will become necessary once consults are replaced with E/M visit codes.

Delayed PECOS rule hits all services, may stop cashflow for months

12/10/2009

You could face a stream of denials even if your enrollment information is fully updated in CMS's online Provider Enrollment Chain Ownership System (PECOS). All it takes is a referral for an item or service - any service, including lab tests or even office visits - that comes from another provider whose information isn't up-to-date in PECOS.

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