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Issue #171 - April 20, 2011
AAPC EdgeBlast
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Additions to CPT® Errata Tap Rules, Guidelines

The American Medical Association (AMA) released additions to its CPT® Errata on April 1 and then again on April 12. The document includes updates and corrections to the code set as reflected in the 2011 CPT® Professional Edition. Most of the changes correct typographical errors, which could potentially lead to miscoding.

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July 1 HCPCS Changes Announced

The Centers for Medicare & Medicaid Services (CMS) recently announced a number of changes to HCPCS Level II codes effective at the end of the second quarter (July 1). Changes include new codes for oxygen, wound care, headaches, and other new initiatives.

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Check Your MPPR Claims for Errors

The Centers for Medicare & Medicaid Services (CMS) notified providers in a Provider Partnership email, April 14, that the Fiscal Intermediary Shared System (FISS) was using a rate file that reflects a 20 percent multiple procedure payment reduction (MPPR) that is appropriate for non-institutional claims, rather than the 25 percent reduction that is appropriate for institutional claims. As a result of this error, all therapy services subject to the MPPR with dates of service on or after Jan. 1 have been incorrectly paid. CMS has instructed Medicare contractors to install a corrected rate file in early May, and to adjust claims that were paid incorrectly no later than June 30.

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HHS Seeks Fraud and Abuse Law Waivers for ACOs

The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) published in the Federal Register (Vol. 76, No. 67) April 7 a notice regarding accountable care organizations (ACOs) with comment period. Together, these federal agencies are seeking public comment on the proposal for waivers of certain fraud and abuse laws in order to carry out the Medicare Shared Savings Program.

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Medicare Over/Under Payments Have New Interest Rate

The interest rate Medicare contractors will charge/pay for claims underpayments/overpayments has changed. Beginning April 19, the private consumer interest rate is 11.00 percent—compared to 11.25 percent in the previous reporting period (Jan. 24 - April 18).

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UnitedHealthcare Public Designation Display Postponed

UnitedHealthcare has pushed back the reconsideration and display dates for its UnitedHealth Premium® physician designation program. The reconsideration period has been extended until May 1 to accommodate any physicians who may have questions about their designation determinations, the insurer said.

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Coding Tips

New Policy Concerning Oxygen Equipment
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Learn the ABCs of Providing an AWV
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New Specialty Code for Imaging Accreditation
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AAFP Releases New Electronic Prescribing Resource
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Palmetto GBA: Thermal Capsulorrhaphy Non-covered
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Medical News

Ingenix Soon OptumInsight
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Medicare Bill Would Expose Docs' Billing
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PQRS URL Changes
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Biometric ID Cards May Cut Medicaid Fraud
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Coding Job Links

AAPC Job Database

AAPC Employment Forums

Featured Items
Additions to CPT Errata
July 1 HCPCS Changes
MPPR Claims Errors
HHS Seeks Law Waivers
Medicare New Interest Rate
UnitedHealthcare
Coding Tips
Medical News
Coding Job Links


























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