Ophthalmology and Optometry Coding Alert
More Fee Cuts in Store for 2004
CMS released a list of the high-volume services facing big changes as part of its draft regulation for the 2004 Physician Fee Schedule. The draft was published in the Aug. 15 Federal Register and providers have until Oct. 7 to comment. The biggest news in the rule is that CMS still expects to slash physician payments by 4.2 percent across the board next year.
But some services face a much bigger cut than just 4.2 percent. Many nursing facility care codes are slated for double-digit decreases in their non-facility RVUs. The hardest hit will be 99311 (Subsequent nursing facility care), which will drop from an estimated $40.83 to $32.07. Other codes include 99301 (was $71, now $58.85), 99302 (was $96.75, now $79.29), 99303 (was $119.92, now $98.32), 99312 (was $62.54, now $52.86) and 99313 (was $85.71, now $72.95).
Some of these same codes will see smaller drops or even modest increases in their facility-based RVUs. For example, 99311 will increase from $30.53 to $32.07, and 99312 will rise from $50.40 to $52.86. Meanwhile, two home visit codes, 99348 and 99350, will drop about 10 percent to $66.60 and $152.94, respectively.
Even as CMS simplified coding for skin lesions, generally, it whacked several big-ticket lesion removal codes. For instance, CMS slashed the estimated non-facility payment 67210 (treatment of retinal lesion) from $604.39 to $547.64.
The draft 2004 Physician Fee Schedule regulation is at http://cms.hhs.gov/physicians/.
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