Medicare Compliance & Reimbursement

Plus: New HCPCS modifier debuts in July Most physicians don't want to wait until June 30 to arrive before they know whether they'll be saved from the 10.8 percent pay cut that's due to hit Medicare providers on July 1. Hopefully the promising news that came from Capitol Hill this week is an indication that lawmakers don't want to wait that long, either. On April 8, Sen. Max Baucus (D-MT), who chairs the Senate Finance Committee, indicated that the Senate would vote on Medicare funding increases by mid-May. Although many non-physician groups are worried that boosts to physician pay would cut payments to other Medicare providers, no one knows for sure just how legislators would fund the potential physician payment increases. In Other News ... • If you were hoping for new HCPCS codes to cure your coding woes next quarter, CMS dashes your dreams with the new code update. The HCPCS quarterly update, which announces revisions, deletions and additions to HCPCS codes and modifiers, only introduces one change effective July 1. You'll be able to report new modifier CG (Policy criteria applied) in July, which features a "C" coverage code, which stands for "Carrier judgment." • The number of plastic surgery procedures performed in America is growing steadily with no sign of a slowdown, recent data from the American Society of Plastic Surgeons (ASPS) shows. Almost 12 million cosmetic plastic surgery procedures were performed in 2007 -- a seven percent increase from 2006 and a 59 percent increase from 2000, the ASPS reveals in its latest procedural statistics report. 5.1 million reconstructive plastic surgery procedures were performed last year. Cosmetic plastic surgery spending increased by 9 percent to $12.4 billion in 2007, the study shows. • CMS will be bringing dialysis centers into the 21st Century with new minimum standards that dialysis facilities must meet to attain Medicare certification. The new standards, outlined in a final rule that was published in the April 4 Federal Register, focus mainly on improving patients' quality of care in dialysis settings. "Facilities must work with patients to achieve and maintain the best possible outcomes of care," said Barry M. Straube, MD, CMS' chief medical officer and director of the CMS Office of Clinical Standards & Quality. To read the final rule, visit http://www.cms.hhs.gov/CFCsAndCoPs/downloads/ESRDdisplayfinalrule.pdf.