Anesthesia Coding Alert

If you've been dreading having to repay Medicare for overpayments you received earlier this year during the 2003 Physician Fee Schedule implementation,
you can rest easy. CMS will not require Medicare carriers to collect money originating from overpayments after all.
 
The problem began when the 2003 Physician Fee Schedule was not implemented until March. As a result, physician claims for services in January and February may have been paid incorrectly if they were submitted after March 1. CMS had directed Medicare carriers to adjust these claims beginning in July and start the process of collecting overpayments from physicians.
 
That plan changed when CMS announced June 26 that it was canceling the massive adjustments scheduled for July.
 
The result: You won't receive a letter from Medicare demanding that you return any overpayments for services in January or February. Also, your patients won't receive copies of these letters either, which probably would have caused quite a bit of confusion.
 
This is good news for practitioners, patients and carriers. Many carriers seemed reluctant to implement the correction process; some expressed surprise that CMS was asking for the corrections because the incorrect payments were Medicare's fault in the
first place.
 
American Medical Association (AMA) staff began working with CMS in February to smooth out the correction process. Several carrier medical directors pressed the agency to cancel the adjustments, which is what eventually happened. CMS plans to recoup some of its losses by adjusting the sustainable growth rate allowance, although individual physicians shouldn't notice the change because it will be a fraction of a cent.
 
While practitioners are relieved to know they don't have to refund overpayments, the carrier will process an adjustment and demand a refund if you were overpaid for services and bring it to the carrier's attention. You should also still contact CMS if you were underpaid for services so you can be reimbursed accordingly.
 Contact your local carrier if you have other questions about the canceled paybacks.