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Issue #161 - November 17, 2010
AAPC EdgeBlast

2011 MPFS Final Rule Reduces Pay Rates
The Centers for Medicare & Medicaid Services (CMS) issued a final rule with comment period Nov. 2, updating payment policies and rates under the Medicare Physician Fee Schedule (MPFS) for physicians' services furnished in 2011. The 2011 MPFS final rule addresses a number of provisions in the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) and some payment rates will drop.

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2011 OPPS/ASC Final Rule Raises Rates
A final rule with comment period went on display Nov. 2 in the Federal Register, updating 2011 payment policies and rates for both hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The final rule with comment period also implements several health care reform provisions and provides the Centers for Medicare & Medicaid Services (CMS) the opportunity to institute several other changes to Medicare policy.

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CMS Updates Home Health Payments for 2011
The Centers for Medicare & Medicaid Services (CMS) filed with the Office of the Federal Register (OFR), Nov. 2, a final rule to update the Home Health Prospective Payment System (HH PPS) for 2011 and implement various Affordable Care Act (ACA) provisions, effective Jan. 1, 2011. The impact of the ACA provisions, wage index and market basket updates, and case-mix coding adjustments are expected to decrease home health agency (HHA) payments by approximately $960 million, or 4.89 percent, in 2011.

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What's in Store for 2011 HCPCS Level II Codes
Among the 2011 HCPCS Level II code changes the Centers for Medicare & Medicaid Services (CMS) posted Nov. 2 are 147 new codes and modifiers and more than 286 deleted codes. Changes include the addition of pass-through codes, a large number of G procedures/professional services codes, and many injectable drugs, among others.

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CLIA Waived Tests Released for First Quarter 2011
The Centers for Medicare & Medicaid Services (CMS) updated, Nov. 5, its list of waived tests approved by the Food and Drug Administration (FDA) under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), and instructed Medicare administrative contractors (MACs) to do the same. To ensure accurate claims payment, clinical diagnostic labs should follow suit.

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Coding Tips

New Year, New Edit for TC of Pathology Services
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CMS Updates DMEPOS Competitive Bidding Program Files
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Medical News

Study Challenges Benefits of Robotic-Assisted Laparoscopic Hysterectomy
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Test Yourself Online
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Featured Items
MPFS Reduces Rates
OPPS/ASC Raises Rates
CMS Updates Payments
2011 HCPCS Level II
CLIA Tests Released
Coding Tips
Medical News
Test Yourself Online
Coding Job Links

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