Medicare Compliance & Reimbursement
Why CPT 2007 Makes Billing 33254-33256 Almost Impossible
You may have celebrated new maze procedure codes too quickly.
CPT 2007 includes five new codes for the maze procedure (33254-33256 and 33265-33266) that allow you to specify whether the procedure was modified, extensive or extensive with cardiopulmonary bypass, plus two endoscopic codes. Coders rejoiced because "it will be useful to distinguish" between the types of maze procedures, according to coder Michele Wann.
Bad news: But CPT 2007 also includes a note stating that you can't bill 33254-33256 with any open-heart surgery codes. This will reduce the usefulness of these codes dramatically, complains Monica Holodnik, accounts manager with Pittsburgh Cardiothoracic Associates.
The note reads: "Codes 33254-33256 are only to be reported when there is no concurrently performed procedure that requires a median sternotomy or cardiopulmonary bypass." If you do bill for any such procedure, you should report the maze procedure using unlisted code 33999. CPT 2007 also lists all the dozens of codes you can't bill with 33254-33256, including coronary artery bypass graft (CABG) and ascending aortic graft.
The Society of Thoracic Surgeons (STS) had fought for these new codes, but now the STS will have to go back and fight for "G" codes that you can use along with open heart surgeries, Holodnik complains.
Her surgeon occasionally performs the maze procedure alone, but almost always performs it with another open heart procedure, Holodnik says. And when the surgeon performs a maze procedure alone, it's usually endoscopic--and these instructions don't apply to the endoscopic codes anyway.
So this means that in spite of these exciting new codes, Holodnik will still be stuck billing unlisted codes, she laments.
Medicare Compliance & Reimbursement
- PHYSICIANS:
For You And Your Patients, Talk Isn't Cheap Anymore
But CMS will reduce your payments by 5 percent overall.
There's good news and bad news [...] - HOSPITALS:
You'll Get A Payment Increase In 2007, But Medicare Will Demand More Quality Reporting
CMS is concerned about the 12-percent jump in hospital outpatient expenditures.
Although you may get excited [...] - HHAs:
Your Reimbursement Could Hang In The Balance On Election Night
How the elections may determine the fate of home care.
Home health agencies (HHAs) shouldn't count [...] - PART D:
Industry Groups Argue Over Part D Doughnut Hole
Consumer group sees gap coverage for only generics as useless to seniors.
After the Department of [...] - GENERAL SURGERY:
Anatomic Location Is Now A Factor For Graft Preparation
New skin codes could fit you like a second skin.
You could soon be reaping more [...] - CARDIOTHORACIC CODING:
Why CPT 2007 Makes Billing 33254-33256 Almost Impossible
Navigating new maze codes leaves coders right back where they started.
You may have celebrated new [...] - INDUSTRY NOTES:
CMS Can't See Coverage For Infrared Therapy
Plus: HHAs will enjoy a bigger-than-expected payment boost.
Medicare won't cover infrared therapy devices for treatment [...]
