ICD-9 2011 and ICD-10 2011 both have coding options for a malignant neoplasm of the main bronchus. Both indicate that the codes are appropriate for malignant neoplasms of the carina or hilus of lung.
What’s different: ICD-9 2011 includes simply 162.2…
On Jan. 3, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) opened the registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. It was started in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas and broad participation is invited from eligible professionals and eligible hospitals who wish to participate.
In February, the registration will open in California, Missouri, and North Dakota and in other states during the spring and summer of 2011.
“With the start of registration, these landmark programs get underway, and patients, providers, and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” CMS Administrator Donald Berwick, MD was quoted as saying in the news release. “CMS has many resources available to help providers register and participate, and we look forward to working with eligible professionals and eligible hospitals to facilitate the process, beginning on January 3rd and going forward.”
“It’s time to get connected,” said David Blumenthal, MD, MPP, National Coordinator for Health Information Technology. “ONC and CMS have worked together over many months to prepare for the startup on January 3rd. ONC’s Certified HIT Product List includes more than 130 certified EHR systems or modules and is updated frequently. ONC also has hands-on assistance available across the country through 62 Regional Extension Centers. We look forward to continuing to work with CMS to assist eligible providers in 2011 and future years.”
The news release said that interested providers can acquaint themselves with the programs’ requirements by visiting CMS’ Official Web Site for the Medicare and Medicaid EHR Incentive Programs.
Eligible providers seeking to participate in the Medicaid programs must initiate registration at CMS’…
You report several EEG codes such as 95812 (Electroencephalogram [EEG] extended monitoring; 41-60 minutes) and 95813 (… greater than 1 hour) based on the amount of recording time. But what constitutes recording time?
Jeffrey Cozzens, MD, professor and chair of the neurosurgery division of Southern Illinois University School of Medicine and a presenter at the AMA’s CPT and RBRVS 2011 Annual Symposium in Chicago, addressed the issue during his presentation about neurosurgery and neurology changes for 2011. Keep two things in mind when calculating recording time for these EEGs:
Other EEG codes, however, focus on the amount of physician time rather than recording time. Watch for that specificity in guidelines for 95961 (Functional cortical and subcortical mapping by stimulation and/or recording of electrodes or brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of physician attendance) and +95962 (… each additional hour of physician attendance [List separately in addition to code for primary procedure). If the physician is in attendance for a total of 30 minutes or less, only report 95961 and append modifier 52 (Reduced services) to indicate he didn’t fulfill the full hour represented by the code.
Two codes for special EEG tests now specify who attends during the procedure:
According to information on the…
The recently released HCPCS 2011 code-set reveals a slew of deletions, streamlining your drug coding choices. Cisplatin, cyclophosphamide, and vincristine are among the affected drugs.
This change should simplify billing, particularly if the system your practice or facility uses, such as Pyxis or Lynx, limits you to a single code and billable unit for a drug, says Lisa S. Martin, CPC, CIMC, CPC-I, chargemaster specialist for OSF Healthcare System in Peoria, Ill. “As a consultant, I saw different facilities using only the 100 mg code [for example] for that very reason, so this change should facilitate more consistent and compliant billing practices.”
While these changes have a positive side, “there are always considerations that will arise,” Martin says. For example, if your practice uses different vial sizes, you will need to be alert for the different and specific national drug code (NDC) numbers for the agent dispensed to the patient when you send a claim to a payer who requires NDC information, she warns.
Cisplatin, ordered particularly for patients with metastatic testicular or ovarian neoplasms, or advanced bladder cancers, is one of the many agents affected by the HCPCS 2011 shake-up.
HCPCS 2011 makes a small wording revision to J9060, notes Roberta Buell, MBA, of onPoint Oncology in her Nov. 9 e-Reimbursement newsletter:
Delete code J9062 (Cisplatin, 50 mg). It will no longer be available for use in 2011. You should use J9060 to report cisplatin, brand name Platinol, when supplied for 2011 dates of service.
Cyclophosphamide is an alkalyting agent that works as an antineoplastic and immunosuppressant. You may see it called Cytoxan or Neosar.
At 1 unit per 100 mg, J9070 (Cyclophosphamide, 100 mg)…
Despite adjusted rate of 33.9764, overall change is zero.
The President locked in a zero percent adjustment to your Medicare Part B payments but that doesn’t mean you’ve got the same rate.
The Medicare and Medicaid Extenders Act of 2010, wh…
If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.
The change: In the past, you could collect for tobacco cessation counseling for a patient with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage, any smoker covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare recognized practitioner who can work with them to help them stop using tobacco.”
“For too long, many tobacco users with Medicare coverage were denied access to evidencebased tobacco cessation counseling,” said Kathleen Sebelius, HHS secretary, in an Aug. 25 statement. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”
Count Attempts and Minutes
The new tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. That means your physicians and coders should know how to correctly document and report the sessions.
“Medicare allows billing for two counseling attempts in a year, but each attempt can occur over multiple sessions, with four sessions per attempt,” explains Jennifer Swindle, CPC, CPC-E/M, CPC-FP, RHIT, CCP-P, director of coding and compliance for PivotHealth LLC in Brentwood, Tenn.
According to section 12 of chapter 32 of the Medicare Claims Processing Manual, “Claims for smoking and tobacco use cessation counseling services shall be submitted with an appropriate diagnosis code. Diagnosis codes should reflect: the condition the patient has that is adversely affected by tobacco use or the condition the patient is being treated for with a therapeutic agent whose metabolism or dosing is affected by tobacco use.”
Swindle says 305.1 (Tobacco use disorder) is one diagnosis supporting…
You won’t face the same nail-biting payment woes in 2011 as you did this year, thanks to a Senate Finance Committee bill that will freeze Medicare pay at current levels for another 12 months. The House of Representatives passed the Medicare and M…
Get ready to change your flu vaccine product code 90658 to one of four Q codes.
For 2010, report 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) to signify that your physici…
Medicare beneficiaries will be thrilled that Medicare will cover annual well checks.
The Center for Medicare introduces a new benefit of wellness visits for beneficiaries annually, except during the year of their Welcome to Medicare exam. You’ll use …
Medicare Physician Fee Schedule rate won’t be cut 23 percent.
Although the government appeared poised to take a big bite out of your next Medicare Part B payments, you now have another month before you need to worry about losing pay. That’s because…