AAPC February 8, 2007
Edge Blast Header

Issue #70

Top News

Cardiac Catheterization Goes to Carrier Pricing, and Back Again

Flu Reports —Will the Real Numbers Please Step Forward

Unpredictable Market Shifts Patient Access to Part B Drugs

Correction—ASC Regulations in the 2007 OPPS Final Rule

AAPC News

Nominations for 2006 Coder of the Year and Networker or the Year are now being accepted, click here.

Nominations must be submitted by February 16, 2007


Nominations for 2007 National Advisory Board are now being accepted, click here.


CRN (Coding and Reimbursing Network) Institute, a partner of AAPC, has announced the addition of an online 18-credit Medical Billing and Coding Certificate Program at Drexel University in the College of Nursing and Health Professions.

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EdgeBlast Test Yourself

Read the EdgeBlast and Earn CEUs Toward Your Annual Renewal

You can now earn continuing education units (CEUs) by reading the Academy’s EdgeBlast. Simply answer the five questions found in the EdgeBlast Test Yourself at the end and submit your answers at the time of your renewal, using the same process you follow monthly for the Test Yourself in the Cutting Edge. Each EdgeBlast (there are two issued each month,) will feature five questions that can earn you .5 CEUs, for a total of 12 CEUs annually.

Workshops

Workshops - Get informed by attending an AAPC workshop in your area. Click here for a schedule and registration.

Visit our locate a workshop page for details.

AAPC Audio Conferences

A perfect way to stay
informed of the industry without leaving home.

Visit our Audio Conference page for details or contact AAPC at 800-626-2633.

National Provider Identifier (NPI) Update

Providers should continue to include legacy identifiers, as well as associated provider identifier types, on their NPI applications. If reporting a Medicaid legacy number, include the associated state name. Providers assigned NPIs, and who did not include these identifiers when applying, should go back into the National Plan and Provider Enumeration System (NPPES) and update their information with legacy identifiers used for billing services with all health plans. Providers should make sure that these legacy identifiers are the ones used to bill for services and should be sure that the NPPES is updated with this information for all health plans.  The Centers for Medicare and Medicaid Services (CMS) said the information is critical for health plans and health care clearinghouses in the development of crosswalks to aid in the transition to the NPI.

To date, over 1.6M providers have obtained an NPI. The deadline is May 23, 2007.

A new Special Edition MLN Matters article is posted on the CMS web site at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0679.pdf


Chris Fraizer

Top News

by Chris Fraizer, MA, CPC
Cardiac Catheterization Goes to Carrier Pricing, and Back Again

The American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI) have accomplished the impossible: they convinced the Centers for Medicare and Medicaid Services (CMS) to reverse its decision to carrier price the cardiac catheterization CPT® codes (93539–93540).


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Flu Reports—Will the Real Numbers Please Step Forward

The influenza season is more overwhelming than you might expect and, according to one study, the numbers are highly overrated.

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Unpredictable Market Shifts Patient Access to Part B Drugs

A Medicare Payment Advisory Commission (Medpac) report to congress suggests a re-tooling of the Medicare pays physicians for physician-administered drugs and drug administration services, particularly in regards to how the program limits drug access for patients without supplement insurance.


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Correction—ASC Regulations in the 2007 OPPS Final Rule

Due to space limitations in the February 2007 Cutting Edge, the following sidebar was inadvertently left out of the story about the ASC. Information in the sidebar is important when answering question #6 in the Test Yourself section of the magazine. We apologize for the error.


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EdgeBlast Test Yourself

By answering the following questions you can earn .5 continuing education units to apply toward your annual Academy certification renewal. Simply answer the questions and send in a copy of your work when submitting your CEU package. Put the number of each EdgeBlast included in your submission. The number is available at the top of the page.

Answers to the questions are not always found directly (word for word) in the EdgeBlast in which they appear. While often related to the EdgeBlast content, they require additional resources such as your ICD-9-CM, CPT® and HCPCS manuals.

And don’t forget about the new CEU policy: CEU submissions will be submitted every two years instead of every year. The number required to submit for single certified members will be 36 every two years, 48 every two years for double certified members, and 60 every two years for triple certified members.


1. What distinguishes the reporting of code 93503 from 93501 (cardiac catheterization codes)?

Answer:
2. According to CPT® Guidelines, what are services included with cardiac catheterization?

Answer:
3. What are the codes to report for the administration of the Influenza vaccine (Medicare and non-Medicare)?

Answer:
4. What is the diagnosis code for Legionnaires’ disease? Give a description of the disease and explain why it is classified in the ICD-9-CM range 480–487.

Answer:
5. How would you code a single IV push during an office visit that also resulted in an evaluation for an earache?

Answer:

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