In Coding
Apr 5th, 2018
The multiple procedure payment reduction (MPPR) means that if a healthcare provider performs multiple procedures during a single patient encounter, Medicare (and many commercial insurers) typically will pay “full price” for only the highest-valued procedure. The reason is explained in Chapter 1 of the National Correct Coding Initiative (NCCI) Policy Manual: Most medical and surgical ...
In Billing
Jun 26th, 2013
by Nancy Clark, CPC, CPC-I Effective January 2013, reduced payment has been made for specific ophthalmologic diagnostic codes. These codes are identified in the Medicare Physician Fee Schedule with the new Multiple Procedure value of “7.” Diagnostic ophthalmology services subject to MPPR include (code listed with short descriptor): 76510 Ophth us b & quant a ...
In Billing
Apr 15th, 2011
The Centers for Medicare & Medicaid Services (CMS) notified providers in a Provider Partnership email, April 14, that the Fiscal Intermediary Shared System (FISS) was using a rate file that reflects a 20 percent multiple procedure payment reduction (MPPR) that is appropriate for non-institutional claims, rather than the 25 percent reduction that is appropriate for ...