AMA Proposes Medicare Billing Codes for End of Life Consultations

By Mary E. Vandenack.

Continued efforts by the American Medical Association (“AMA”)  are being made to get physicians paid for consultations related to end of life and advanced care discussions. The Centers of Medicare and Medicaid Services (“CMS”) will review proposed codes submitted by the AMA to determine whether the codes will be included in the 2015 physician fee schedule, expected to be released in November. Various legislation has been  introduced in Congress seeking to get physicians paid for end of life discussions. If CMS includes the codes in its fee schedule, such legislation will become unnecessary.

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HHS Confirms October 2015 Deadline for ICD-10

By M. Thomas Langan II.

The deadline to implement ICD-10 has been confirmed to be October 1, 2015.  The implementation date was most recently postponed from October 1, 2014 to an undetermined date.  In its statement announcing the new deadline, CMS explained that the delay will give the healthcare industry “ample time” to prepare for the change.

The notice from CMS can be found here: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-07-31.html.

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CMS Seeks to Set New ICD-10 Deadline for October 1, 2015.

Although CMS has not officially established a new deadline for ICD-10 implementation after the 2014 deadline was delayed, October 1, 2015 appears to be CMS’s preferred deadline. In an unrelated rule recently released by CMS, it stated that it planned to schedule the ICD-10 transition deadline for that date.

CMS has since indicated that it expects to release an interim final rule in the near future that will officially set the ICD-10 implementation date for October 1, 2015. Like the prior deadlines, providers will be obligated to use ICD-9 until September 30, 2015.

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Study Identifies Common Medicare Billing Issues

CMS has released results from its recent study on common billing mistakes by health care providers. Among the most common mistakes include unbundling – the practice of submitting claims by piecemeal to maximize reimbursements for tests and procedures that are required to be submitted together at a reduced cost.  Other common mistakes are using the wrong diagnosis code to support an MRI and coding a subsequent Annual Wellness Visit improperly as an initial wellness visit.

 The study also revealed that common forms of underbilling include coding for the wrong surgery and using a lower level of Evaluation and Management than the documentation supports.

More information on the study can be found at: Comprehensive Error Rate Testing (CERT).

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ICD-10 Deadline Delayed at Least 1 Year

The implementation deadline for ICD-10 has been delayed to at least October 1, 2015.  Congress has previously pushed back the deadline several times, most recently to October 1st, 2014.  The law provides that the implementation date may not be prior to October 1st, 2015, leaving open the possibility of it being further extended.  President Obama signed the bill into law on April 1st, 2014.

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CMS Releases Website to Help Prepare for ICD-10

The Centers for Medicare and Medicaid Services has recently released a website designed to help health care practice owners implement ICD-10.  The website can be located at http://www.roadto10.org.  The website provides a basic overview of ICD-10, an FAQ section, and sample form documents.

The compliance deadline for ICD-10 is currently slated for October 1, 2014.

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