Part B Insider (Multispecialty) Coding Alert
CMS Expands Coverage for Prothrombin Time to Include Additional Diagnoses
PDF
Plus: CMS offers a new resource for billing and coding preventive services to Part B.
The new decision, which CMS issued on Jan. 23, notes that CMS previously covered prothrombin time monitoring only for patients with mechanical heart valves who were on warfarin.
The new change, however, will allow practices to bill this service for chronic, oral anti-coagulation management in patients with mechanical heart valves, chronic atrial fibrillation, or venous thromboemoblism, according to a MLN Matters article on the topic.
Patients must meet the following criteria to qualify:
• The patient must have been anticoagulated for at least 3 months prior to use of the home INR device
• The patient must undergo an educational program on anticoagulation management and the use of the device prior to its use in
the home
• Self-testing with the device should not occur more frequently than once a week.
Even better: CMS has made this change retroactive to March 19, 2008.
For more information on the new national coverage decision, visit the CMS Web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6138.pdf.
In other news ...
• If your head spins when you try to make sense out of coding and billing for Medicare's preventive services, CMS has a new tool that can help.
CMS' Expanded Benefits Brochure provides health care professionals with an overview of Medicare's coverage of three preventive services: the Welcome to Medicare Exam, ultrasound screening for abdominal aortic aneurysms, and cardiovascular screening blood tests.
To view the brochure, visit the CMS Web site at http://www.cms.hhs.gov/MLNProducts/downloads/Expanded_Benefits.pdf.
Part B Insider (Multispecialty) Coding Alert
- Part B Documentation:
3 Quick Tips Help You Implement New ABN Form
Combo form streamlines your work. If you aren't using CMS's new advance beneficiary notice (ABN) [...] - Part B Revenue Booster:
Recognize Incident-to Services Or Pay the 15-Percent Penalty
Hint: Doctor's schedule will be the key. Under incident-to rules, qualified nonphysician practitioners (NPPs) can treat [...] - Part B Revenue Booster:
Clip and Save: Let This Tool Do the Incident-To Decision Making for You
Follow the flow chart to determine when incident-to services are billable. Suppose your nonphysician practitioner [...] - Hospice:
Hospices May Need Additional Details From Physicians Based on New Recommendations
MedPAC also targets 5 hot spots for focus areas, which could burden some hospices if [...] - Reader Question:
Get to Know the Ins And Outs of Medicare's E-Prescribing Bonus
Three G codes could help you tell your payer why you deserve a bonus for [...] - Use These 3 Easy Tips for Headache-Related Nerve Blocks
Correct 64400 and 64405 coding helps ensure payment. If your practice is looking to add [...] - Physician Notes:
CMS Expands Coverage for Prothrombin Time to Include Additional Diagnoses
Plus: CMS offers a new resource for billing and coding preventive services to Part B. CMS [...]