Part B Insider (Multispecialty) Coding Alert

Published on Sat Aug 05, 2006 PDF

Here's your checklist of what the future really holds

These are the times that try coders- souls. With so many changes being talked about for next year, it's hard to know what's written in stone, and what's scribbled in sand.

But don't worry. Here's a complete list of all the changes that have actually become law or final regulations. (Of course, Congress could always go back and rewrite the law, and the Centers for Medicare & Medicaid Services could change its regulations.)

- Fee schedule cut. Once again, the law calls for your payments to fall by around 4.6 percent next year, unless Congress takes action. Congress has acted to prevent the last few cuts, but it allowed a steep cut to go through in 2002. Since this is an election year, you can expect some change, predicts Quinten Buechner with ProActive Consulting in Cumberland, WI. Status: final--for now.

- Imaging cuts. In 2006, if you do imaging scans on two body parts that are next to each other, Medicare will reduce the technical component by 25 percent for the second scan. For 2007, that will become a 50 percent cut. If you supply vascular ultrasound services, your reimbursement could drop 30 percent, notes attorney William Sarraille with Sidley Austin Brown & Wood in Washington. Status: final.

- Nuclear medicine. Next year nuclear medicine (including PET scans) will come under the Stark self-referral law. This means your practice won't be able to own a PET scanner unless the ownership fits into one of the Stark exceptions. For example, you could own a PET scanner or other nuclear medicine device as long as you keep it in the office where you treat patients. Status: final regulation.

- Oncology changes. A demonstration project that pays oncology practices for reporting on some measures of quality will expire in 2007, unless CMS takes action to renew it. Status: final.

- Enrollment changes. All of your doctors must have national provider identifiers (NPIs) by May 2007. Status: final.

(Editor's Note: Refer to an article later in this issue for a list of changes that are proposed but not final for next year.)