Part B News | Editors' Blog

CMS delays requirement for signatures on labs

by: Grant Huang Jan 10, 2011

CMS is freezing a rule that would require your physicians and non-physician providers (NPPs) to sign requisitions for lab tests. This requirement, introduced in the 2011 Physician Fee Schedule (PFS) final rule, was to take effect Jan. 1, 2011 and would've applied to all lab tests paid under the clinical laboratory fee schedule. We covered this issue of lab signatures in a recent edition of the NPP Report.

More on AWV, end-of-life care planning

by: Charles Fiegl Jan 10, 2011

CMS has gone through an expedited rule making process to remove the voluntary end-of-life care provision from annual wellness visits (AWV). Part B News subscribers can read our full coverage of this story, but here is CMS's full explanation for why it is scrubbing end-of-life care from the services.

"... we published the proposed rule entitled 'Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011.' In response to this publication, we received comments from health care providers, and others urging us to add voluntary advance care planning as a specified element of the definitions of both the 'first annual wellness visit' and the 'subsequent annual wellness visit.' The commenters stated that their recommendations were based upon a number of recent research studies, and the inclusion by the Medicare initial preventive physical examination (IPPE) provisions of a similar element in the existing IPPE benefit.

Report: White House cuts end-of-life plan from AWV

by: Charles Fiegl Jan 5, 2011

A New York Times report says the Obama administration is removing the end-of-life care planning component to the new annual wellness visit (AWV) service.

The end-of-life plan, which is voluntary and requires patient consent, is just one of several parts to the service. The planning was added in the finalized 2011 Medicare Physician Fee Schedule, but it was not included in the proposed rule released in July.

Robert Gibbs, the White House press secretary, said on Wednesday that this prevented the public from commenting on the provision during the rulemaking process.

CMS and HHS would not comment on the report Wednesday morning. Also, CMS had not issued any guidance on removing the component to the service.

2011 conversion factor goes down, pay goes up?

by: Charles Fiegl Jan 3, 2011

CMS released an updated 2011 conversion factor just days before the New Year, as the last 2010 Part B News newsletter was going to press. This left us with little time and space to write much detail about how the new conversion factor, $33.9764, will impact physician payments.

The conversion factor is just one component of the Medicare payment formula. So, you shouldn't be surprised that some payments, in particular E/M codes, increased in pay despite the 2011 conversion factor dropping 7% from the 2010 rate of $36.8729.

CMS releases transmittal with details on new wellness visits

by: Grant Huang Dec 6, 2010

You've got the details of annual wellness visit in writing, thanks to a CMS transmittal released Dec. 3. There are few surprises in the 35-page document, which is effective Jan. 1, the same day you can first start billing Medicare for this service. Transmittal 2109 does offer a full list of the remittance advice codes you'll see in the unhappy scenario that your annual wellness visit (AWV) gets denied.

While we have written extensively about the major requirements that could cause an early, edit-based denial of the AWV, knowing exactly how the error codes will read may help expedite your appeal efforts. Here's a breakdown, with special attention on the new codes (read more about CMS wellness visit transmittal) ...

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