Several Washington news outlets and health care lobbyists report Senate Finance Committee aides reached a tentative deal Monday night to prevent the massive Medicare payment cut scheduled for Jan. 1. A proposed one-year pay fix delaying a 30% cut to reimbursement rates could be brought to the Senate floor as early as this week.

Politico's Jennifer Haberkorn writes that the $19 billion pay patch would be offset with tax subsidies established by the Affordable Care Act. The money was set aside for Americans to purchase  insurance plans after 2014. However, some Democrats might balk at the idea of using these funds as Democrats had fought to increase subsidies for  Americans purchasing plans in new health insurance exchanges.

The proposal may also extend other Medicare payment provisions, such as the therapy cap exemptions, that are set to expire on Dec. 31.

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) ...

The presentation slides from the CPT Annual Advisors Meeting in October have been posted up on the AMA's website. I found them while looking for information on the new modifier 33, which is not available as of this posting.

During the meeting, the AMA gave a presentation on consultation codes (pdf). CMS discontinued consult billing in the Medicare program in 2010. The AMA and other physician groups lobbied CMS to change course, but CMS has not yet relented.

A few presentation slides by Peter Hollmann, MD, the vice-chair of CPT's Editorial Panel, show the billing confusion caused by eliminating consults. Consult codes don't evenly crosswalk to the E/M services you're supposed to bill in lieu of the inactive codes. Below are partial excerpts of crosswalks used in the presentation, but please note that this information is not intended to be coding advice for physicians.

CMS is replacing the CPT code you've been accustomed to using for flu vaccines and is adding five new Q codes, with an enforcement date of Jan. 1, 2011. For dates of service starting Jan. 1, 90658 (flu vaccine, 3 years and older, $11.37) will no longer be payable. The five new Q codes are actually payable right now, and retroactively to Oct. 1, 2010. You may submit claims with these new codes on an individual basis or via roster billing. Here's a full list of the codes (read more on new Q codes for flu vaccines) ...

Any Medicare pay fix bill sent to the Senate would take a back seat to certain tax issues affecting all taxpayers and government funding.

Senate Minority Leader Mitch McConnell (R-Ky.) placed a letter in the Senate record Wednesday that states expiring tax cuts need to be the top priority. Republicans will block other bills until "the Senate has acted to fund the government and we have prevented the tax increase that is currently awaiting all American taxpayers." The letter is signed by all 42 members of the Republican caucus.  

"Without Congressional action by December 31, all American taxpayers will be hit by an increase in their individual income-tax rates and investment income through the capital gains and dividend rates," the letter says. "If Congress were to adopt the President's tax proposal to prevent the tax increase for only some Americans, small businesses would be targeted with a job-killing tax increase at the worst possible time."

Click here to watch of video of Sen. McConnell