Radiology Coding Alert

A new modifier may be forthcoming to distinguish bypassing CCI from bypassing MPPR. CMS released the 2013 Medicare Physician Fee Schedule (MPFS; final with comment period) for services furnished on or after January 1. Not surprisingly, the American College of Radiology (ACR) is speaking up about the expansion of the Multiple Procedure Payment Reduction (MPPR). The MPPR applies to designated imaging services and reduces reimbursement for second and subsequent imaging services at the same session. The 2013 MPFS states Medicare will now "apply the MPPR to both the PC and the TC of advanced imaging procedures to multiple physicians in the same group practice (same group NPI). Under this policy, the MPPR will apply when one or more physicians in the same group practice furnish services to the same beneficiary, in the same session, on the same day" (emphasis added). One of the reasons CMS gives is that "application of [...]