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Issue #136 - November 4, 2009
AAPC EdgeBlast

Hospitals, ASCs Will See 2010 Payment Update
Hospitals who successfully participated in quality data reporting for outpatient services will receive a 2.1 percent inflation update in their 2010 payment rates for services furnished to Medicare beneficiaries in outpatient departments, according to the Centers for Medicare & Medicaid Services (CMS). Ambulatory surgical centers (ASCs) will receive a 1.2 percent inflation update beginning Jan. 1, 2010 using the same payment methodology as in 2009.

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2010 MPFS Final Rule Still Holds Surprises
The Centers for Medicare & Medicaid Services (CMS) announced, Oct. 30, final changes to 2010 Medicare Physician Fee Schedule (MPFS) policies and payment rates. Taking into account all changes in the final rule, CMS projects a payment increase between 5 and 8 percent for health care professionals paid under the MPFS. That’s the good news...

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Mark the Red Flags Rule Date for June 1, 2010
The Federal Trade Commission’s (FTC) compliance deadline for creditors and financial institutions to develop and implement an identity theft prevention program under the Red Flags Rule was delayed—yet again. The implementation date originally set for Nov. 1, 2008 has been delayed three times to 2009 dates; May 1, Aug. 1, and Nov. 1. At the request of Congress members, the latest implementation date now extends to June 1, 2010.

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Medicare FFS Q&A Addresses H1N1
The Centers for Medicare & Medicaid Services (CMS) updated, Oct. 14, its Medicare Fee-for-Service (FFS) Q&As to address H1N1-related questions circling among the health care industry.

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2010 DME Reasonable Charge Update is Status Quo
The 2010 payment limits for splints and casts will be based on 2009 payment limits. Due to a -1.41 percent change in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending June 2009, the inflation indexed charge (IIC) update factor for 2010 is 0 percent.

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Act Now: DMEPOS Competitive Bidding Program Underway
The Centers for Medicare & Medicaid Services (CMS) began accepting bids for the Round One Rebid of the Medicare Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) on Oct. 21. Qualified DME suppliers in nine areas have until Dec. 21 to submit bids.

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Annual Clotting Factor Furnishing Fee Update
The annual update to the clotting factor furnishing fee is $0.170 per I.U. and is effective from Jan. 1, 2010 to Dec. 31, 2010. This fee is included in the published payment limit for HCPCS Level II clotting factor billing codes (J7189-J7195) and added to the payment for a clotting factor when no payment limit is published either on the Average Sales Price (ASP) Medicare Part B Drug Pricing File or the Not Otherwise Classified (NOC) Pricing File.

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What Insurers Need to Know About Mandatory Reporting
Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) added new mandatory reporting requirements for group health plans (GHP) and non-group health plans (NGHP), such as liability insurance (including self-insurance), no-fault insurance, and workers’ compensation.

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Coding Tips
CPT® 2010: Major Changes for CCT
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Cardiac MRI May Be Covered, May Not
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Catheter Codes Cause Confusion
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Noridian Identifies Top 5 Claim Submission Errors
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Two RACs Add to List of Issues Under Review
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Escape Computer Errors for Accurate Claims Payment
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Know Carrier Guidelines When Coding H1N1
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Medical News

FDA Gives EUA for IV Peramivir
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FDA Approves Fluarix for Pediatric Use
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Fistula First Breakthrough Initiative Provides Roadmap to Reach Goal of 66%
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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.

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Featured Items
Hospitals, ASC Payment
2010 MPFS Final Rule
Red Flags Rule
Medicare FFS Q&A on H1N1
2010 DME Charges
DMEPOS Bidding
Clotting Factor Fee
Mandatory Reporting
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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