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Issue #134 - October 7, 2009
AAPC EdgeBlast

Annual Seasonal Flu Payment Allowance Update
The Centers for Medicare & Medicaid Services (CMS) released, Oct. 2, an annual update to influenza (flu) payment allowances for the 2009-2010 season.

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H1N1 Vaccine Reporting Codes in CPT®
The American Medical Association (AMA) has created a new CPT® code specific to vaccine administration and revised an existing code to include the H1N1 vaccine.

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OIG Releases 2010 Work Plan
The Office of Inspector General (OIG) released, Oct. 1, its annual Work Plan for fiscal year 2010. The Work Plan outlines activities the OIG intends to initiate or continue in its ongoing endeavor to right wrongs in Health and Human Services (HHS) programs and operations, such as Medicare.

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Stark Law Revisions Go into Effect
New anti-self-referral rules in the Stark law went into effect Oct. 1. Being unprepared or remaining ignorant of these revisions may cause some physician-hospital arrangements to fall out of compliance, according to AMNews (Sorrel, 9/28).

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New DMEPOS Requirements Go into Effect
Suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) must now be accredited and bonded to qualify for Medicare reimbursement.

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NGS Denies Claims as Experimental in Error
National Government Services (NGS) posted on its Web site Sept. 30 a notice that the Part A/B Medicare Administrative Contractor (MAC) experienced a claims processing issue impacting Medicare Part B claims submitted from Sept. 16 through Sept. 23.

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MRI for Blood Flow Measurement May Be Covered
Your practice may now be able to get paid for magnetic resonance imaging (MRI) when used for blood flow measurement. The Centers for Medicare & Medicaid Services (CMS) posted, Sept. 28, a decision memo stating that “the blanket noncoverage of MRI for blood flow determination at 220.2 is no longer supported by the available evidence.”

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Pulse Insulin Therapy Remains Noncovered
Outpatient intravenous insulin therapy (OIVIT) is to remain nationally noncovered. The Centers for Medicare & Medicaid Services (CMS) recently concluded that OIVIT does not improve health outcomes and is not reasonable and necessary for any indication.

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CMS: LCD Exceptions May be Warranted
The Centers for Medicare & Medicaid Services (CMS) issued, Sept. 25, new guidance that delegates Medicare contractors the authority to make an exception to clinical criteria described in a local coverage determination (LCD) on a case-by-case basis and even reconsider an LCD if evidence upholds necessity.

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See What’s New for Category II
The American Medical Association (AMA) posted several Category II code updates in recent weeks. The latest additions, deletions and revisions will affect how physicians report certain conditions in 2010, but you won’t find them listed in the CPT® books until 2011.

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IPPS 2010 Final Rule Published
Changes to the Inpatient Prospective Payment Systems (IPPS) for acute care and long-term care hospitals and 2010 payment rates were published in a final rule Aug. 27 in the Federal Register.

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Dell Joins Throng of EHR Vendors
Computer hardware giant Dell has joined the fray of electronic health record (EHR) vendors. The Round Rock, Texas-based company announced Sept. 10 its new Affiliated Physician EMR Solution.

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Coding Tips
New FDG Reporting Requirements Delayed
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RACs Update CMS-Approved Audit Issues
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Modifier Mix-up Causes Excessive Claims Denials
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Get Paid for Genioglossus Advancement
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Member’s Tip: Testosterone Replacement Therapy Coding
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Member’s Tip: Pain-free Coding of Morton’s Neuroma
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Member’s Tip: Report Imaging Guidance Only Once with Multiple FNAs
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Filed on Time? Prove it!
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Medical News

Health Alert: New Heparin Less Potent
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PET Services Expected to Increase in 2010
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Do You Have an EMR Story?
Do any of you have a story to tell about the purchase of an EMR system for your practice? How long did it take to install? How much did it cost? Was it easy to use? Has it accomplished what you wanted? Are your physicians seeing the same, more or less patients per day since? Do the physicians like it? We’d love to hear from you! Please send your stories directly to reed.e.pew@aapc.com

Test Yourself Online
The Test Yourself questions can be accessed online at www.aapc.com/testyourself/. Once you go there and take the test, you can automatically grade your answers, correct any mistakes, and have your CEUs automatically added to your CEU Tracker for submission.

Coding Job Links
AAPC Job Database

AAPC Employment Forums

Featured Items
Flu Payment Allowance
H1N1 Reporting
2010 Work Plan
Stark Law Revisions
DMEPOS Requirements
NGS Denies Claims
MRI Blood Flow
Pulse Insulin Therapy
CMS: LCD Exceptions
New for Category II
IPPS 2010 Final Rule
Dell a EHR Vendor
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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