Ob-Gyn Coding Alert

Get ready for another year of nail-biting to find out if your Medicare payments will be slashed. "The update to the physician fee schedule conversion factor is -21.2 percent for CY 2010, notes the 2010 Medicare Physician fee schedule Final Rule, printed in the Federal Register that will be published on Nov. 25.

Traditionally, Congress has stepped in to reverse such dramatic cuts before they took place, but unless that happens this year, you'll face a conversion factor of $28.4061 effective Jan. 1, according to calculations in the Federal Register.

Example: If your ob-gyn bills Medicare for a TAH/BSO (58150, Total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]) in 2009, your relative value units (RVUs) would be 26.07. With the current conversion factor of $36.0666, that equals $940.26.

In 2010, the RVUs for 58150 will increase to 26.88. Before you cheer, if you multiply this by the dramatically reduced $28.4061 conversion factor, you'll only get $763.56. That's a payment decrease of $176.70 for this procedure.

Many physician practices expressed angst at such low reimbursement rates, with some indicating that they would become non-par with Medicare if the cuts take effect. "Physicians have been getting more disgruntled over the past several years with the threat of cuts, and if their reimbursements are cut by such an egregious amount, this will finally send them over the edge," says Charlene Burgett, MS, CMA(AAMA), CPM, CPC, CMSCS, administrator with North Scottsdale Family Medicine in Arizona.

"It is becoming more and more difficult dealing with all health plans, especially Medicare," Burgett says. "It won't be worth accepting Medicare due to the fact that there is more red tape and government bureaucracy with nothing to show for it if there is a reduction in reimbursement."