Part B Insider (Multispecialty) Coding Alert
'Set-In-Advance' Stark Setback Buys Physicians Time
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare July 7 received a reprieve from the Centers for Medicare & Medicaid Services. CMS on April 25 once again delayed the effective date of a controversial element of the Stark physician self-referral regulations - a single sentence in the Jan. 4, 2001, Stark rule that deals with percentage compensation arrangements and the definition of "set in advance." This is the third time CMS has delayed the rule, which is now effective Jan. 7, 2004. The agency says the "set in advance" issue will be worked out definitively in the Stark Phase II rule. To see the notice delaying the rule, go to www.access.gpo.gov/su_docs/fedreg/a030425c.html.
Many of the exceptions to the Stark rule that apply to compensation arrangements can be invoked only if the amount of compensation is set in advance. CMS is grappling with whether its interpretation of "set in advance" automatically excludes percentage compensation deals from the Stark exceptions - a reading that could leave teaching hospitals, physician practices and medical foundations scrambling to rework thousands of contracts.
Part B Insider (Multispecialty) Coding Alert
- DIAGNOSIS CODING:
Be Very Virtuous When Submitting V Codes - REIMBURSEMENT:
MedPAC Stands by Physician Pay Raise Recommendation - CORRECT CODING INITIATIVE:
CMS Reverses CCI Edits for TEE
When the doors of reimbursement close on a procedure you perform regularly, don't despair. Sometimes [...] - DIAGNOSIS CODING:
When Can V Codes Stand Alone?
How long after you remove a tumor can it serve as the primary diagnosis for [...] - TELEMEDICINE:
Telemedicine, Regular Medicine Both Have Same Result
What's the difference between counseling someone on managing her diabetes via video and in person? [...] - FRAUD & ABUSE:
OIG May Dislocate Your Joint Venture
Durable medical equipment companies won a starring role in the HHS Office of Inspector General's [...] - COVERAGE:
CMS Plans to Reach Out for Tech Advice
If you think you're having a hard time keeping up with the galloping advances in [...] - LMRPS:
Carriers Unveil Spate of Draft LMRPs
Need summer beach reading? Your carrier may have just the thing. Carriers are putting out [...] - INCIDENT-TO BILLING:
Ask Your Local Carrier About Incident-To Requirements
How far away from a physician can nonphysician practitioners stray before incident-to billing goes away? [...] - CODING:
Are You Using Modifier -59 Correctly? Quick Test Will Say for Sure
If you're slapping modifier -59 on your claims like there's no tomorrow, doomsday could in [...] - COMPLIANCE:
Drugmaker Guidance Could Have Wide Reach to Physicians
If you're accepting free services or payments as an inducement to prescribe a particular drug, [...] - DIAGNOSIS CODING:
CDC Readies New ICD-9 Codes
Starting in October, you could have a whole new way to look at Pap smear [...] - Physicians Still Lag on HIPAA, Survey Says
The compliance deadline for the HIPAAprivacy rule has come and gone - but physicians still [...] - E-CONSULTS:
ACP Seeks to Put 'E' in Medicare - DOCTOR'S NOTES:
Physician Payment Reforms Could Be on the Way
Don't panic! That's the message one prominent Washington law firm is sending physicians. At press [...] - Look Twice at These 5 JV Warning Signs
You should take notice if your joint venture exhibits any of the following five elements, [...] - UPCODING:
E/M Upcoding Leads to $1.36 Million Payout
Here's one more reason to be sure your evaluation and management coding practices are up [...] - COMPLIANCE:
'Set-In-Advance' Stark Setback Buys Physicians Time
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare July 7 received a [...] - Montana Blues Sings Apologetic Song
One carrier took April Fools' Day a little too far this year, it now admits. [...]
