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Issue #142 - February 3, 2010
AAPC EdgeBlast

CMS Makes Available NPI Registry File
The Centers for Medicare & Medicaid Services (CMS) has made available a file that contains the National Provider Identifier (NPI) and the name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in the Provider Enrollment, Chain and Ownership System (PECOS) that contain an NPI).

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CMS Approves Three Organizations to Accredit Imaging Suppliers
Come Jan. 1, 2012, a provision in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires all suppliers of the technical component (TC) of advanced diagnostic imaging services suppliers to be accredited by an accreditation organization designated by the Secretary of Health and Human Services (HHS). To that end, the Centers for Medicare & Medicaid Services (CMS) has named three national accreditation organizations—The American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC) and The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO)—for the job.

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AMA Adds to CPT® 2010 Corrections
Get out your CPT® 2010 book and a pencil — it’s time to make a few more corrections. The American Medical Association (AMA) issued an updated corrections document on Jan. 21.

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Payers Scramble to Update Systems
As we reported in a previous article, President Obama signed the Department of Defense appropriations bill into law on Dec. 19, 2009, delaying a 21.2 percent reduction in physician fees until March 1. In response, just days later, the Centers for Medicare & Medicaid Services (CMS) released the January 2010 Physician Fee Schedule (PFS) file that contains the 2010 relative value units (RVUs) and temporary conversion factor.

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MedPAC Proposes 2011 Medicare Provider Payment Updates
Two months ahead of schedule, the Medicare Payment Advisory Commission (MedPAC)—an independent congressional agency charged with advising Congress on a wide range of Medicare issues—voted Jan. 15 on recommendations for 2011 Medicare provider payment updates.

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New Medicare Overpayments, Underpayments Interest Rate Set
Underpaying Medicare claims will cost your practice a little more now than it did just a few weeks ago. The Department of the Treasury recently notified the Department of Health and Human Services (HHS) of the private consumer interest rate that may be assessed for underpayments and overpayments. On the bright side, the new interest rate could work in your favor if the Centers for Medicare & Medicaid Services (CMS) underpays your practice.

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RACs Add to Lengthy CMS-Approved Issues
There’s certainly no grass growing under the feet of the Centers for Medicare & Medicaid Services’ (CMS’) four appointed Recovery Audit Contractors (RACs). Each company has been hard at work posting new CMS-approved issues for review. Whereas RACs’ initial focus seemed to be on outpatient services, the target now also seems to be on inpatient services.

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Increased Payments for Ambulance Services Expire
As a reminder, effective for dates of service on or after Jan. 1, reimbursement for ground and air ambulance service claims will no longer include an increase in the ambulance fee schedule due to the expiration of two Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) provisions.

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Palmetto Prepares for WPS Transition
On April 19, some providers currently serviced by Wisconsin Physician Service (WPS) will transition to jurisdiction 1 (J1), administered by Part A and Part B Medicare Administrative Contractor (A/B MAC) Palmetto GBA.

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Idaho, Illinois Insured Gain Control Over Denials
Idaho and Illinois residents have been granted the legal right to externally appeal health insurance benefit denials. This brings the number of states without such a law down to just five: Mississippi, Nebraska, North Dakota, South Dakota, and Wyoming. The law, however, varies from state to state.

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Family Practice Says “Meaningful Use” Will Be Tough
The American Academy of Family Physicians (AAFP) believes the proposed Meaningful Use rules will be hard on small- and medium-sized practices, and wants changes made.

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Coding Tips
Anti-markup Policy Changes Effect Physicians/Suppliers
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Submit a Lot of Duplicate Claims? Expect a Call
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CMS Pub Defines Inpatient vs. Outpatient
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NGS Implements Prepay Edit for 99310
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Medical News

ACIP Approves 2010 Adult Immunization Schedule
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Wound-healing Centers Boost Hospital Revenue
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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.

Coding Job Links
AAPC Job Database

AAPC Employment Forums

Featured Items
CMS NPI Registry
CMS Imaging Suppliers
2010 CPT® Corrections
Updating Payer Systems
2011 MedPAC Updates
Medicare Payments
RACs Add Issues
Ambulance Payments
WPS Transition
Control Over Denials
FP & "Meaningful Use"
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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CPT® codes Copyright 2010 American Medical Association. All Rights Reserved. CPT® is a trademark of the AMA. No fee schedules, basic units, relative values or related listings are included in CPT®. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.