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Issue #163 - December 15, 2010
AAPC EdgeBlast

Congress Votes to Stop Physician Pay Cut
Congress has passed legislation to counteract the Sustainable Growth Rate (SGR) formula that would have reduced Medicare physician reimbursement rates. The U.S. House of Representatives voted 409-2 in favor, Dec. 9, and the Senate voted by unanimous consent, Dec. 8, for the Medicare and Medicaid Extenders Act of 2010 (HR 4994). The bill was presented to President Obama Dec. 10 for signing. If and when the president signs the bill, it will postpone the 25 percent pay cut to physicians until Jan. 1, 2012.

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Update 2011 CPT with Corrections
The American Medical Association (AMA) has released the first errata for the 2011 CPT codebooks. The AMA has compiled a number of changes in a corrections document, dated Nov. 8, which is posted on the AMA website.

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Physicians Not Creditors, Congress Says
The U.S. House of Representatives passed without objection, Dec. 7, the Red Flag Program Clarification Act of 2010 (S.3987). This legislation limits the type of creditors that must comply with the often-delayed Red Flags Rule. The Senate unanimously passed the bill on Nov. 30. Under the bill, physicians are no longer considered creditors and are exempt from the Red Flags Rule requirements.

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Clinical Lab Fee Schedule Update Released
The 2011 Clinical Lab Fee Schedule annual update has been released. The update, effective Jan. 1, 2011, includes 16 new codes and 1,188 modified codes. Under the new fee schedule, local clinical laboratory rates are reduced by 1.75 percent while payments for reasonable charges for all other lab services goes up 1.1 percent.

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PECOS Ordering/Referring Edit on Hold
With the implementation of Section 6405 of the Patient Protection and Affordable Care Act (Affordable Care Act), some physicians will need to enroll in the Medicare program for the sole purpose of certifying or ordering services for Medicare beneficiaries. Rumors of when this policy goes into effect, however, are greatly exaggerated.

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Just Say "No" to Vendor Perks
Money, free travel, grants, honoraria, and other valuable goods and services sound nice but when they're offered by drug makers and other vendors to physicians, they're called illegal kickbacks. Kos Pharmaceuticals, a subsidiary of Abbott Laboratories, found that out the hard way. The Delaware-based company agreed, Dec. 7, to pay more than $38 million to settle criminal and civil allegations under the False Claims Act.

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Coding Tips

Report Annual Wellness Visits with New G Codes
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SCODI Code Retired, Three Codes Eye Its Spot
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Gulf Oil Spill Claims: Use CS and BP
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Correctly Code Non-Emergent Ambulance Transport Services
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Medical News

Advisory Panel: Lower BMI for LAP-BAND
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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
Physician Pay Cut Stopped
Update Your 2011 CPT
Physicians Not Creditors
Clinical Lab Fee Schedule
PECOS Order/Refer Edit
Refuse Vendor Perks
Coding Tips

Medical News
Test Yourself Online
Coding Job Links

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