Part B Insider (Multispecialty) Coding Alert
PHYSICIAN NOTES:
CMS Spending on Physician and Clinical Services to Grow 6 Percent in 2009
Published on Mon Feb 02, 2009 
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Plus: Payers may not honor new outpatient therapy cap amount until April,CMS says.
This year, CMS will shell out six percent more for Medicare physician and clinical services -- but that amount will drop next year, if the SGR formula goes into effect.
According to a Feb. 24 CMS press release, growth in national health expenditures will decelerate in 2010 to 4.6 percent, thanks to the projected 21 percent cut to Medicare physician payment rates required under the sustainable growth rate (SGR) "called for in 2010 under current law."
Potential good news:
CMS does acknowledge in its press release that "in every year since 2002, Congress has acted to override application of the SGR formula to reduce physician payments."Keep an eye on the
Insider -- we'll be following Congress and whether its members act to override the SGR for 2010.Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- FACET JOINT COMPLIANCE:
Physicians Overbilled Facet Joint Injections by $96 Million, OIG Says
CMS warns MACs to be on the lookout for improperly billed injections. Making a $50 [...] - PRIVACY:
Be Prepared -- Stimulus Plan Strengthens HIPAA Rules
Many HIPAA regulations are now applicable to your practice's business associates. If you've been lax [...] - FACET JOINT COMPLIANCE:
Avoid OIG Scrutiny With Facet Joint Injection Savvy
Our tips help you report modifier 50 the right way. Think billing bilateral facet joint [...] - IDENTITY THEFT:
Prepare for Red Flag Rule by Squelching Opportunities for Identity Theft at Your Practice
Implementation guideline is right around the corner. Does it apply to you -- and are you [...] - IDENTITY THEFT:
Get The Right Facts in Your Red Flag Program And You'll Be All Set for the May 1 Deadline
These sample items can help you get on the right track -- and can help you [...] - READER QUESTION:
You Will Need a Diagnosis Code for a Feigned
Hint: Select the diagnosis code based on the physician's documentation, even if you end up [...] - Part B Coding Coach:
5 Steps Ensure Your Observation Care Success
Code service only when making admittance decision to prevent denials. Although CPT offers two observation [...] - PHYSICIAN NOTES:
CMS Spending on Physician and Clinical Services to Grow 6 Percent in 2009
Plus: Payers may not honor new outpatient therapy cap amount until April,CMS says. If CMS [...] - In other news ...• The outpatient therapy cap is $1,840 for 2009, but the claims system won't reflect that until April.
It will reject therapy claims that exceed the 2008 cap amount of $1,810 until then, [...] - In other news ...• If you try to bill Medicare for oxygen equipment repairs or service with HCPCS code E1340 after April 1, you won't get very far.
Starting in April, DME MACs will begin denying E1340 claims with dates of service Jan. [...]
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