News You Can Use: Punch In 3 New Infusion Pump Codes

You'll need to punch these three temporary Q codes (for infusion pumps) in to your chargemaster starting Oct. 1, according to a July 18 CMS program memorandum (PM): Q4075 (Injection, acyclovir, 5 mg), Q4076 (Injection, dopamine hydrochloride, 40 mg), and Q4077 (Injection, treprostinil, 1 mg). 
 
 Johnson & Johnson's Cypher stents may soon lose their status as the only FDA-approved drug-eluting stents on the block, thanks to a recent submission by Boston Scientific Corp. BSC's "TAXUS" stent, which delivers paclitaxel (an anticlogging medication) and props open blocked arteries, may hit the market by the end of the year if all goes smoothly with the federal government.
 
 In the July 25 edition of the Federal Register, CMS released new proposed rules, including the following: 1.) Elimination of the statement of intent (SOI) procedure that extends filing time for Medicare claims for an extra six months. CMS intended the SOI procedure to benefit Medicare beneficiaries, who may need more time to file due to poor health or lack of familiarity with the claims process. But the government found that in reality, beneficiaries were rarely filing SOIs themselves, and rarely even filed their own claims. 2.) Alteration of the way Medicare calculates interest on over- and underpayments to providers and other healthcare professionals. The proposal suggests a reduction in interest and simplification of the calculation process in order to "better align [the agency's] practices to a commercial business model."

Rather than assessing interest prospectively - which means even if 30 days haven't passed, CMS treats any delinquency as a month overdue - CMS would assess retrospectively, no longer calculating a full interest cycle on periods less than 30 days. If you want to submit comments on these proposals to CMS, your deadline is Sept. 23, 2003. To view the proposal itself, visit http://www.access.gpo.gov/su_docs/fedreg/a030725c.html.
 
 Also in the Federal Register, Medicare reiterates that it axed coverage of these three items: multiple-seizure electroconvulsive therapy, electrodiagnostic sensory nerve conduction threshold testing, and noncontact normothermic wound therapy - so make sure you've crossed them off your list of paid procedures.
 
Keep your eyes open for the results of two upcoming meetings recently scheduled by CMS. The Advisory Panel on Ambulatory Payment Classification Groups will hold session Aug. 22, and the Medicare Coverage Advisory Committee will meet Sept. 9.
 
 Throw away your copy of CMS' PM A-03-032 from May 2 regarding the requirements for patient status code 43. The agency has issued a new and improved set of guidelines for the code: Starting Oct. 1, you should use code 43 (Discharged/transferred to a federal hospital) whenever the discharge destination is a federal hospital, regardless of whether the patient resides [...]

- Published on 2003-08-13