Part B Insider (Multispecialty) Coding Alert
Say Goodbye To 50-Percent Pay Cut For G0289
Medicare changes multiple procedure indicator for arthroscopyYou can look forward to $48 more in reimbursement when you report G0289 with your chondroplasty claims, thanks to a new Medicare Transmittal.
On Sept. 1, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 1047, which changes the multiple surgery payment indicator for code G0289 (Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage [chondroplasty] at the time of other surgical knee arthroscopy in a different compartment of the same knee) from -2- to -0.- This means that as of Oct. 2, Medicare carriers will no longer take the multiple procedure discount of 50 percent when you report G0289 with other procedures.
Because you cannot report G0289 as a stand-alone procedure, this change means that every time you bill G0289, you will collect twice the reimbursement that you collected in the past.
Medicare doesn't pay enough in general for orthopedic procedures, so -receiving 100 percent of the allowable is huge,- says Margaret Atkinson, business manager with Centennial Surgery Center.
Unfortunately, the volume of cases where this change will have an impact under Medicare is relatively low for Centennial, says Atkinson. But since many other insurance companies copy Medicare's policies, this means that other payors may soon start paying 100 percent for the procedure as well. And that will mean a much bigger reimbursement boost to Centennial.
Contact your non-Medicare payors: Make sure they know about the change to Medicare policy, experts urge. Review your contracts with insurance companies to make sure they follow Medicare rules, says Atkinson. Also, make sure they actually pay 100 percent of the allowable for add-on codes and 50 percent for secondary procedures. Also, check whether other payors accept HCPCS codes at all.
Resource: To read the full Transmittal, visit the CMS Web site at www.cms.hhs.gov/transmittals/downloads/R1047CP.pdf.
Part B Insider (Multispecialty) Coding Alert
- REIMBURSEMENT:
Fight Against 5.1 Percent Cut Begins With Time Already Running Out
Physician spending grew much less quickly than expected
There's no time to lose to save Medicare [...] - ORTHOPEDICS:
Say Goodbye To 50-Percent Pay Cut For G0289
Medicare changes multiple procedure indicator for arthroscopyYou can look forward to $48 more in reimbursement [...] - PE-RVU Changes Could Cut Major Procedures By 10 Percent
If the Centers for Medicare & Medicaid Services goes ahead with plans to change how [...] - REIMBURSEMENT:
Can A Lame Duck Save You From The Chopping Block?
Congress considers plan that would keep 5-percent cuts for some doctors
Forget pay-for-performance. One new plan [...] - AUDITS:
Don't Start Auditing Your E/M Visits Without A Baseline
Follow up with problem doctors every few months
Sometimes you can have a problem with your [...] - DERMATOLOGY:
Getting Paid For Simple Repairs Isn't Always Simple
Don't give up on reimbursement for G0168
Sometimes the carriers move in mysterious ways--and you have [...] - Part B Coding Coach:
Don't Miss This Chance to Improve Your Practice's Coding Accuracy
Self-audits are well worth the time, experts say
Although some coders believe that self-audits are only [...] - Clip and Save:
Let This Self-Audit Checklist Be Your Guide
Consider 9 criteria when you sit down with your audit materials
If [...] - PHYSICIAN NOTES:
Radiologists, Beware--CMS Is Looking For Double Billings
Utah Court Takes Managed Care Antitrust Claim With A Grain Of Salt
Radiology providers billed Medicare [...]
