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Cms says to bye bye to 95 em guide lines???

  1. #1
    Exclamation Cms says to bye bye to 95 em guide lines???
    Medical Coding Books
    I am eager to know if this statement is true, if yes, when. amny of us will need to re arrange our coding tools ir order to keep complaint.
    I learned of it in a seminar this week. Does anyone have more information related?

    Saul Sanabria, CPC.

  2. #2
    Location
    North Carolina
    Posts
    3,126
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    I have not heard this. Did the seminar representative present tangible proof?

  3. #3
    Location
    Charleston, South Carolina
    Posts
    641
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    I too read something on this recently. I am not in the office today, but will look for it next week and post here when I find it. You may want to search at www.cms.gov to see if there is anything posted there. I dont' currently code E/M so did not pay too much attention to it at the time. Its probably in my pile of "read when I get a chance" articles.
    Machelle Morningstar, CPC, COC, CEMC, COSC
    AHIMA Approved ICD-10-CM/PCS Trainer

  4. #4
    Location
    Overland Park, KS
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    1,166
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    I searched the CMS website and I did not find anything about this. I would not be so quick to jump the gun here. If this was true, it would be all over the coding sites. AAPC would have it already posted to the News section of this website. I want to see it in writing before I change anything.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. #5
    Location
    Sioux Falls South Dakota
    Posts
    358
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    I also searched CMS, and our carrier, Noridian, web sites and found nothing. I've sent an e-mail to Noridian and will post their reply here. Of course, they always say they can take up to 45 days to answer, so we may well know before then!
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  6. #6
    Location
    Everett, WA
    Posts
    886
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    I am glad this is being asked. Several weeks ago I wrote and requested a couple of times whether there was anything coming up in the near future regarding any changes or possible overhauls to the 95 or 97 guidelines. Received no responses, so will follow this thread closely....Suzanne E. Byrum, CPC

  7. #7
    Location
    Sioux Falls South Dakota
    Posts
    358
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    I received a response from Noridian. According to them, the E/M service guide from July 2009 is the one still in use (which includes the 95 DG). Further, if CMS does decide to change which guidelines it uses for its E/M policies, Medicare providers and contractors will be informed. Then, of course, a blurb to sign up for the e-mail list so I can be notified of any changes (I'm already signed up).

    So, until we hear any more from them, I think we're OK. Of course, who knows when it could change?
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  8. Default
    I have heard the rumblings also but can't find anything in writing either. I do think the change is coming. The '95 guidelines are very loose. I think the change will be slipped in just as the consult change was. Early rumblings, discussion/venting and then the change is made.

    Basically I consider this as an unofficial leak to what is coming down the pipe which gives providers (and non-MC payers) the chance to get used to the idea.

    I think it is a result of the RACs, to streamline that process and stop the double auditing work under '95 and '97 to whatever is most favorable to the practice

    I think it will be handeled the same way as the consults with a formal announce Oct 1 but mandatory Jan 1

    Just my 2-cents. I guess we will see.

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