Part B Insider (Multispecialty) Coding Alert
Grassley Provisions Unpopular With Many
The cancer community, including patient advocacy groups, oncologists, oncology nurses and others, continues to advocate "balanced reform," says attorney Larri Short with Arent Fox Kintner Plotkin & Kahn in Washington, D.C. "Cuts to AWPand drugs are acceptable only with commensurate increases in practice expenses," she says. "The Grassley amendment cut drug reimbursement but failed to address practice expenses at all," Short adds. "The cancer community believes the amendment would have had an adverse impact on access."
"We'd love to see anything that gives providers more money as long as it doesn't take money away from other providers," says Paul Speidell, government affairs representative with the Medical Group Management Association. If the Grassley bandwagon starts up again, he says MGMA hopes legislators will "try to make sure that oncology payments were appropriate in relation to anything that happens with the AWP levels."
Part B Insider (Multispecialty) Coding Alert
- POLITICS & POLICY:
Senate Rural Health Plan Goes Back To The Barn
A U.S. Senate amendment to the Republican tax bill that would have boosted payments to [...] - REIMBURSEMENT:
Rural Reforms Snard in Medicare Reform Tangle
Now that the U.S. House of Representatives has shot down Sen. Charles Grassley's (R-Iowa) provision [...] - Providers Still Working on SGR Fix
Providers continue to work on Capitol Hill to win reform of the formula Medicare uses [...] - Appeals:
Avoid Appeals Doldrums With Documentation
Cash-strapped carriers may begin pushing your appeals to the bottom of their in-boxes unless you [...] - RVUS:
CMS Slashes More Than a Dozen Codes
CMS giveth, and CMS taketh away.
At the start of 2003, [...] - COMPLIANCE PERSPECTIVES:
Docs' Coding Savvu Can Boost Reimbursement, Enhance Compliance
Many physicians are loathe to add coding knowledge to their repertoire, but biting the coding [...] - Understand Modifiers for Non-Covered Services
Want to bill Medicare for a service you're sure it's going to deny? You still [...] - COVERAGE:
National Coverage Policies Should Rule, Report Says
Confused by your carrier's local coverage policies? If the General Accounting Office gets its way, [...] - LOCAL COVERAGE POLICIES:
CIGNA Policies Limit Sinus Endoscopy
In Tennessee, Cigna Healthcare unveiled two new draft local medical review policies with comments due [...] - REIMBURSEMENT:
When You Take Extra Time, Make It Count
If your physician is spending more than the usual amount of time with a patient, [...] - ABNs:
Game of Musical Diagnoses Leaves Patient Without Chair
A signed advance beneficiary notice gives you the right to tell a patient, "I told [...] - LUNG-VOLUME REDUCTION:
Study Suggests Who Gains From Disputed Surgery
The Centers for Medicare & Medicaid Services opened a national coverage determination process on lung-volume [...] - MEDICARE REFORM:
AWP Cuts, Redistribution Not Dead Yet
Rural physicians can cling to hope of relief on Medicare payment levels, while oncologists and [...] - MEDICARE REFORM:
Grassley Provisions Unpopular With Many
The cancer community, including patient advocacy groups, oncologists, oncology nurses and others, continues to advocate [...] - PHYSICIAN NOTES:
Carriers Tout Safeguard Hauls
Medicare carriers are boasting once again about the financial fallout from their medical review, fraud-fighting [...] - CHART:
Prolonged Services
Documentation of physician time is critical to charge for prolonged services (CPT 99354 [...]
