The American Medical Association 2015 CPT® Codebook is now available. It contains 9,951 total Current Procedural Terminology (CPT) codes and more than 500 code changes: 266 new, 147 deleted and 129 revised codes. The good news for anesthesia providers and coders is that the only change to the anesthesia code section (00100-01999) is the deletion of three codes, all due to low utilization. The deleted codes are:
00452 Anesthesia for procedures on clavicle and scapula; radical surgery
00622 Anesthesia for procedures on thoracic spine and cord; thoracolumbar sympathectomy
00634 Anesthesia for procedures in lumbar region; chemonucleolysis
The bulk of the coding changes for 2015 fall within the surgical section and the impact, if any, regarding most of these changes will become apparent upon the release of the American Society of Anesthesiologists (ASA) 2015 A Guide for Surgery/Anesthesia CPT® Codes 2015 Crosswalk (not available at press time). Since many of these surgical...
Even though there has been a substantial amount of information published regarding the implementation of ICD-10 over the last ten years, there are many misconceptions that continue to plague the physician community. Rumors run rampant; some are valid while others are completely unfounded. Frequently we hear the need for change in healthcare, yet resistance to change continues to stifle our ability to move forward. The unknown is a scary place. It is more comfortable to work with an established system that is flawed rather than implement a new, technologically advanced system. Reflecting back several years ago with the implementation of the 5010 HIPAA electronic transactions standard, many organizations were negatively affected because they were not prepared, yet after some adjustments, 5010 is successfully operating behind the scenes with little to no effort. Let’s review ten questions concerning ICD-10 in an attempt to dispel the myths.
Who developed ICD-10?
The World Health...
If anesthesiologists and pain specialists are like other physicians, at least as far as this question goes, online rating web sites like HealthGrades and Vitals do not provide much useful information on provider quality.
A recent study funded by the American Board of Internal Medicine (ABIM) found that there is little to no association between physicians’ online ratings and how well they score on performance measures or on patient-experience surveys conducted by their own practices. Researchers led by Bradley M. Gray, PhD looked at 1,299 physicians who completed an ABIM Practice Improvement Module® (PIM) in diabetes or hypertension between July 2011 and November 2012. These modules guide physicians through a review of patient data and support quality improvement work and reporting in their practices. PIM patient survey responses and chart abstractions were compared against the ratings physicians received on eight leading, publicly available and free rating websites. Sites were selected from...
If you provide anesthesia for a Medicare patient undergoing a screening colonoscopy, you will be able to collect 100 percent of the allowable amount from Medicare and will not need to bill the patient for any co-payment or deductible, beginning on January 1, 2015. You must, however, identify the service as screening rather than diagnostic or therapeutic through the use of the appropriate modifier on your claim.
In the interest of making preventive care more widely available, a provision of the Affordable Care Act, Section 4104, waived “colorectal cancer screening test” co-payments and deductibles for Medicare beneficiaries. For the same reason—to avoid patient cost-sharing’s becoming “a significant barrier to these essential preventive services”—CMS extended the waiver of coinsurance and deductible to anesthesia services furnished in conjunction with a screening colonoscopy in the Final Rule on the Physician Fee Schedule for 2015.
As CMS observed,
A recent study in The Journal of... 
The last two issues of the Alert reviewed changes to the Physician Quality Reporting System (PQRS) and to the Value-Based Payment Modifier (VM) announced in the Final Fee Schedule Rule for 2015. This week we will note for the record some of the most meaningful numbers in the Final Rule—the conversion factors—and explore developments regarding two of CMS’ transparency ventures, the Physician Compare website and the Open Payments program.
Conversion Factors for 2015
The Final Rule announced two different conversion factors (CFs) for each of two different periods: January 1 through March 31, 2015 and April 1st onward. On April 1st, unless Congress enacts yet another fix to the Sustainable Growth Rate (SGR) formula, the delayed 21.2-percent cut will go into effect. The CFs for the two periods are:
The figures for the first three-month period are slightly different from the CFs for 2014 because of required budget neutrality adjustments and...