Urology Coding Alert

But you won't feel as much of a crunch, thanks to a budget neutrality adjustment. CMS has released the Medicare Physician Fee Schedule for 2009. Despite a lower conversion factor, the news isn't all bleak. In fact, your urology Practice won't likely see much change in reimbursement next year. Here's what you need to know to be ready come January. Some Specialties Fare Better Than Others Don't lose heart when you see CMS's 2009 conversion factor of $36.066 -- a drop from 2008's $38.0870. CMS attempts to make up for the lower conversion factor by boosting the budget neutrality adjustment by 1.1 percent. Therefore, despite the lower conversion factor, the relative value units (RVUs) for some procedures have gone up. What it means to you: While some specialties won't fare as well, urologists will see a 0 percent scheduled change to their reimbursement. Some specialties will see increases, but others will see decreases of 3 and 4 percent, so consider yourself lucky to have no change at all. Where to find it: The specialty information, which comes from Table 48 in the Fee Schedule Final Rule, shows how the new RVU changes will affect each specialty. You can check other specialties online at http://edocket.access.gpo.gov/2008/pdf/E8-26213.pdf. "There is a 6.5 percent, five-year practice expense reduction that has been in the works for the past five years, so without the 1.1 percent increase, we would be seeing a 6.5 percent overall decrease in reimburse-ment," says Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions. "Instead, we are now seeing a 5.4 percent decrease." 99213 Gets Boost CMS reassigned RVU values for many procedures for 2009. While the RVUs for several procedures went down, your reimbursement for the most commonly reported code, 99213 (Office or other outpatient visit ...), rose. Whereas you currently collect $58.90 for 99213 (not including geographic adjustment), you will bring in $61.31 for this service in 2009. Payments for 99214 (Office or other outpatient visit...) will rise from the current rate of $89.89 to $92.33 next year. Many other E/M codes will be reimbursed at higher rates in 2009 than in 2008. For example, office consultations will be paid more in 2009. Medicare paid $122.26 on 99243 in 2008, which will be reimbursed at $124.79 during 2009. Code 99244 paid $179.01 in 2008 and will be reimbursed at $184.30 in 2009. You'll see the same degree of increases 2009 for 99223 (initial hospital visit), 99253 and 99254 (hospital consultations), and 99285 (an ER visit). Procedure changes: The fee schedule cuts fees for some procedures in the office, but increases those fees when performed in a facility. When the urologist performs the [...]