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Question regarding change to 29881

  1. #11
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    When I read the new revisions for chondroplasties I was suprised there wasn't any previous mention of this revision, the doctor's were surprised too, I thought, did I miss something, this seems pretty big to Orthopedics, is the AMA in favor of this new ruling.
    And I agree any compartment now excludes use of G0289.

  2. #12
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    The AMA is the organization that creates and produces the CPT codes so yes they are in favor of this. As far as advance notice you get the notice when you get the new book for the year which you should get somewhere in November or December. Also the AMA has a book that you can purchase called CPT changes which comes out every year. This book explains this change and the rationale behind it. Or you can attend the seminar the AMA puts on in Novemebr of every year to explain the new changes effective for the next year.
    The point is this information is available prior to the effective date, however it is rarely available free and to get it timely you need to plan the purchase of your books so that they arrive prior to January 1.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default AAOS AMA Agreeing with Modifier Change More Info Request
    Quote Originally Posted by orthobiller2000 View Post
    this seems pretty big to Orthopedics, is the AMA in favor of this new ruling.
    .
    Debra, a follow up to your response that AMA is in favor of this. Are you saying that AMA supported the modifier indicator change done by CMS? I cannot find any AAOS discussion on this change. While AMA finalizes and published CPT codes, they are not in charge of CCI edits which are authorized by CMS and published by NTIS.

    Usually, when edits are changed, CMS sends an email to any affected specialty society notifying them of the intended change and allowing them 90 days to comment/challenge the change. I cannot locate any discussion that occurred on the change in 29880 and G0298’s modifier indicator from 1 (allowed) to 0. Sometimes, the email goes to the wrong recipient (for instance, that employee is no longer in that position) or sometimes it just goes unnoticed due to increased workloads from reduced budgets or employee turnover.

    The modifier indicator change effective with CCI 18.0, effective Jan. 1 2012 contradicts the updated 2012 CCI policy manual – Chapter 4 -Bullet #10 which states:

    10. CPT codes 29874 (Surgical knee arthroscopy for removal of loose body or foreign body)
    and 29877 (Surgical knee arthroscopy for debridement/shaving of articular cartilage) should
    not be reported with other knee arthroscopy codes (29866-29889). HCPCS code G0289 (Surgical
    knee arthroscopy for removal of loose body, foreign body, debridement/shaving of articular
    cartilage at the time of other surgical knee arthroscopy in a different compartment of the same knee)
    may be reported.

    I am contacting AAOS to see if they were aware of the modifier indicator change and the still existing manual entry. I will also contact some contractor medical directors and raise this issue. I have taken these actions with two questionable modifier changes in the past that eventually led to two reversals of such “surprise” modifier indicator changes – one affecting pediatrics and one affecting ENT.

    Do you, however, have inside information that AAOS was notified of the intended change by CMS and supported/challenged it -- and it was ultimately accepted?

    Thank you for any further information you can share.

    Sincerely,
    Jennifer Godreau, BA, CPC, CPMA, CPEDC
    Director of Development & Operations, SuperCoder.com, The Coding Institute, LLC jenniferg@codinginstitute.com
    Last edited by Jennifer Godreau; 02-16-2012 at 10:48 AM.

  4. #14
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    Quote Originally Posted by Jennifer Godreau View Post
    Debra, a follow up to your response that AMA is in favor of this. Are you saying that AMA supported the modifier indicator change done by CMS? I cannot find any AAOS discussion on this change. While AMA finalizes and published CPT codes, they are not in charge of CCI edits which are authorized by CMS and published by NTIS.

    Usually, when edits are changed, CMS sends an email to any affected specialty society notifying them of the intended change and allowing them 90 days to comment/challenge the change. I cannot locate any discussion that occurred on the change in 29880 and G0298’s modifier indicator from 1 (allowed) to 0. Sometimes, the email goes to the wrong recipient (for instance, that employee is no longer in that position) or sometimes it just goes unnoticed due to increased workloads from reduced budgets or employee turnover.

    The modifier indicator change effective with CCI 18.0, effective Jan. 1 2012 contradicts the updated 2012 CCI policy manual – Chapter 4 -Bullet #10 which states:

    10. CPT codes 29874 (Surgical knee arthroscopy for removal of loose body or foreign body)
    and 29877 (Surgical knee arthroscopy for debridement/shaving of articular cartilage) should
    not be reported with other knee arthroscopy codes (29866-29889). HCPCS code G0289 (Surgical
    knee arthroscopy for removal of loose body, foreign body, debridement/shaving of articular
    cartilage at the time of other surgical knee arthroscopy in a different compartment of the same knee)
    may be reported.

    I am contacting AAOS to see if they were aware of the modifier indicator change and the still existing manual entry. I will also contact some contractor medical directors and raise this issue. I have taken these actions with two questionable modifier changes in the past that eventually led to two reversals of such “surprise” modifier indicator changes – one affecting pediatrics and one affecting ENT.

    Do you, however, have inside information that AAOS was notified of the intended change by CMS and supported/challenged it -- and it was ultimately accepted?

    Thank you for any further information you can share.

    Sincerely,
    Jennifer Godreau, BA, CPC, CPMA, CPEDC
    Director of Development & Operations, SuperCoder.com, The Coding Institute, LLC jenniferg@codinginstitute.com
    What I am saying is the AMA creats the CPT codes and the rational for the change to the 29880 and 29881 was because they have data that supports that more than 75% of the time when a 29880 or 29881 is performed, the physician also performs the equivalent ofthe 29877, so they combined the descriptors together in one code. They did this with several code combination that met this same test. It had nothing to do with CCI edits it is that the code descriptor has changed and the chondroplasty is now an inclusive component of the 29880 and 29881, read the 2012 descriptors. With this change you can no longer code the G 0289 with these codes
    Last edited by mitchellde; 02-16-2012 at 06:08 PM.

    Debra A. Mitchell, MSPH, CPC-H

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