Part B Insider (Multispecialty) Coding Alert

PHYSICIAN NOTES:

CMS Proposes Artificial Heart Device Coverage

On Feb. 1, CMS proposed coverage -with evidence development- of artificial heart devices for Medicare patients who are enrolled in an FDA-approved study.

-Our proposal relaxes a long-standing non-coverage policy, gives access to our beneficiaries and promotes evidence development through FDA approved studies of this advanced technology,- said Kerry Weems, acting administrator of CMS.

CMS will issue a final national coverage determination this May, but you can comment on the proposed decision by visiting www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=211.

In Other News-

- Thought MLN Matters needed more pizzazz? CMS delivers with its new -Guided Pathways- resource, an interactive Web-based application that allows medical professionals to quickly find information about Medicare issues.

Offering primers on everything from appeals to overpayments to Medicare reimbursement, the new portal strives to be more user-friendly than the main CMS Web site, offering visual entry points to the information that it contains.

To check out the new CMS Guided Pathways resource, visit www.cms.hhs.gov/apps/training/guidedpathways/index.html

- ASCs that have been feeling the squeeze of the 2008 fee schedule can finally face some good news. As part of the ASC final rule (CMS-1392-FC) published last November, CMS listed all of the codes that it considered payable to ASCs.

New CMS Transmittal 1415, however, boosts that list by adding four new HCPCS Level II codes that are payable by Medicare to ASCs, as follows:

- C9237--Injection, lanreotide acetate
- C9240--Injection, ixabepilone
- C9354--Veritas collagen matrix, cm2
- C9355--Neuromatrix nerve cuff, cm.

These codes are effective for payment by ASCs as of Jan. 1. For more information about the HCPCS codes, visit the CMS Web site at www.cms.hhs.gov/transmittals/downloads/R1415CP.pdf.