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Issue #99 - April 16, 2008 
AAPC

Most ICD-9 Changes in Decade Proposed
The Centers for Medicare and Medicaid Services (CMS) announced April 15 its proposed changes to ICD-9-CM for 2009, and the number of new codes this year is the most in more than a decade. More than 330 new diagnosis codes are proposed and will be posted in an upcoming Federal Register.

Included are codes classifying carcinoid tumors by site; secondary diabetes mellitus in its own category 249; more than two dozen new headache codes; retinopathy of prematurity codes by stage; pressure ulcers by stage; and newborn necrotizing enterocolitis by stage. More than a dozen codes associated with Pap smears and HPV and 25 obstetrics and gynecology codes were also added.

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Medicare Advantage Plans '08 3.6% Hike
CMS announced that average reimbursements to providers of private Medicare Advantage (MA) plans will increase by 3.6 percent in 2009. The deductible for Medicare prescription drug plans will increase to $295 in 2009 from $275 this year and the initial coverage limit will increase to $2,700 from $2,510.

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Does Heartsbreath Test Need a NCD?
Menssana Research is asking CMS to consider national coverage for the Heartsbreath test for grade 3 heart transplant rejection. The Heartsbreath test is a new, FDA-approved breath test which detects oxidative stress and may predict the probability of grade 3 rejection in heart transplant recipients who received their transplants in the preceding year.

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CMS Reconsiders PET Coverage
CMS is reconsidering section 220.6 to end requirements for data collection of all oncologic indications for positron emission tomography (PET) except for monitoring response to treatment.

Currently, section 220.6 of the National Coverage Determination (NCD) Manual establishes the requirement for prospective data collection for FDG PET used in the diagnosis, staging, restaging, and monitoring the response to treatment for brain, cervical, ovarian, pancreatic, small cell lung and testicular cancers, as well as for cancer indications not previously specified in section 220.6 in its entirety.

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CMS Not Changing PTA Coverage
After a year of review, CMS has determined that Medicare coverage of percutaneous transluminal angiograph (PTA) should not change.

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MMI is Now Contexo Media®
The Medical Management Institute (MMI) officially has changed its name to Contexo Media®. MMI was acquired by Contexo Media® in June 2006 and the new name now completes the transformation of MMI to Contexo Media®. MMI has provided coding products and education to health care professionals in coding, billing, reimbursement, and compliance.

Contexo Media is a Mindshare sponsor of AAPC.

Test Yourself
Index # EB04022008A

Use this number to document 0.5 CEUs for this EdgeBlast.

By answering the following questions, you can earn 0.5 continuing education units to apply toward your AAPC certification renewal. Simply answer the questions and include the number of the EdgeBlast when submitting your CEUs. The number is available at the top of the page.

1. The Heartsbreath test is a new, FDA-approved breath test which detects:

A. oxygen levels
B. heart rate
C. heart stress
D. oxidative stress

2. The development and use of balloon angioplasty for treatment of atherosclerotic and other vascular stenoses, PTA (with and without the placement of a stent) is a widely used technique for dilating lesions of:

A. peripheral, renal, and coronary arteries
B. coronary and circumflex arteries
C. the aorta
D. superior vena cava and left pulmonary veins

3. CMS announced that the deductible for the Medicare prescription drug plans will increase from $275 this year to how much in 2009?

A. $2,700
B. $285
C. $295
D. $2,510

4. Which is not a cancer that section 220.6 of the NCD Manual establishes the requirement for prospective data collection for FDG PET used in the diagnosis, staging, restaging, and monitoring the response to treatment for?

A. brain
B. prostrate
C. cervical
D. pancreatic

5. What is the conventional procedure used in the diagnosis of all grades of heart transplant rejection?

A. endomyocardial biopsy
B. Heartsbreadth test
C. radioisotope 2-[F18] fluoro-2-deoxy-D-glucose
D. embolization

Test Yourself Online
These same 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.

Note: Beginning next month (May), Test Yourself questions will be available online exclusively.

Changes to EdgeBlast
Prepare for a higher standard of EdgeBlast. We're making the design easier to use, adding more current and relevant news that will help you code, and offering Test Yourself online. We'll continue to make changes over the next few issues and look forward to your comments as we seek to give you a better resource for coding and billing news.


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