Part B Insider (Multispecialty) Coding Alert

Physician Notes:

CDC and FL Health Offer New Advice for Providers As Zika Hits First US Citizens

Published on Tue Aug 16, 2016

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Plus: New MPPR rulings for PC will affect payment for some diagnostic imaging care.

At first, the Zika virus seemed to be something to prepare for when traveling outside of the States, and Part B Insider advised on ways and ideas to treat patients affected on vacation to Zika-infected areas (see Part B Insider vol. 19 no. 20).

But, due to the onset of the Zika virus in Florida with confirmed US cases, the Centers for Disease Control and Prevention (CDC) and the Florida Department of Health have compiled information and resources to guide providers through the prevention, detection, and treatment of the disease.

Originally, the Zika virus was detected only in visitors to the US, but the CDC lists the “locally acquired mosquito-borne cases” at six—all in a small section of Miami-Dade county.

“The Florida Department of Health has identified an area in one neighborhood of Miami where Zika is being spread by mosquitoes,” the CDC Zika resources say. “This guidance is for people who live in or traveled to this area any time after June 15 (based on the earliest time symptoms can start and the maximum 2-week incubation period for Zika virus).”

As we previously mentioned, the Zika virus is most dangerous to pregnant women and to those engaging in sexual intercourse with infected individuals. General bug prevention is the key to escaping infection, says the CDC.

Reminder. If you have patients traveling to or near infected areas in the US, a vaccine is being worked on but does not exist yet to combat the virus. Travelers should pack and wear appropriate clothing and bedding, apply anti-mosquito sprays, and use extreme caution in their activities with regards to the times and areas mosquitos will be most active.

Resources: For the complete CDC Zika virus guide, visit http://www.cdc.gov/zika/index.html.

To reference the Florida Department of Health’s Zika resources, visit http://www.floridahealth.gov/diseases-and-conditions/zika-virus/.

In other news…

It looks like radiology practices have something to smile about. CMS will be paying a little bit more of their fee schedule amounts in relation to the procedural component (PC) with new changes to its Multiple Procedure Payment Reduction (MPPR) system.

“Effective January 1, 2017, MACs shall pay 95 percent of the fee schedule amount for the PC of each additional procedure furnished by the same physician (or physician in the same group practice) to the same patient, in the same session on the same day,” MLN Matters® article CR9647 stated. Currently, Medicare only pays 75 percent of each PC.

According to the article, the technical component (TC) will not be affected, with its MPPR staying steady at 50 percent.

Resource: For a quick link to the MLN Matters^® article CR 9647, visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9647.pdf.