In CMS
Jul 17th, 2017
The Centers for Medicare & Medicaid Services (CMS) has a date in mind for implementing the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging services. In the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS proposes Jan. 1, 2019, as the date when ordering professionals would need to consult specified applicable AUC using a qualified clinician ...
In 2015, the CPT® codebook separated joint injections and aspirations into services “with” and “without” image guidance. This year, CPT® has taken a similar approach with spinal injection services. As of Jan. 1, 62310-63219 are deleted, and replaced with: 62320 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including ...
Amyloid imaging in the Imaging Dementia — Evidence for Amyloid Scanning (IDEAS) Study is a Medicare-approved coverage with evidence development (CED) procedure. This nuclear medicine procedure uses positron emission tomography (PET) imaging to examine how amyloid plaques (a core feature of Alzheimer’s disease) in the brain help to guide doctors in patient treatment, and whether ...
In Coding
Dec 12th, 2016
Question: Can a physicians code separately for reading X-rays or imaging studies taken elsewhere? For instance, could we report the appropriate X-ray CPT® code with modifier 26 Professional component attached? Answer: If another provider (e.g., hospital radiologist) previously read/interpreted the image, and has issued a report, your physician cannot separately code or be paid for ...
In Billing
Jul 19th, 2016
In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) outlines plans to revise Medicare Physician Fee Schedule (MPFS) payment policies for 2017, and make several other policy changes related to Medicare Part B payment. Key Provisions Section II of the MPFS proposed rule focuses on practice expense relative value units (PE RVUs), malpractice relative ...