Part B Insider (Multispecialty) Coding Alert
CMS Official: 'Welcome to Medicare' Not A Problem For Most Docs
While many physician groups have become vocal in their belief that a level-three office visit won't begin to cover the battery of tests included in the 'Welcome to Medicare' physical, the Centers for Medicare & Medicaid Services isn't yet listening.
"I've probably spoken to several tens of thousands of physicians and office managers since the number became pretty well understood," says a CMS official. "I have not had anybody say to me that they think the payment is too low." While physicians won't "get rich" doing the initial physical exam, it should be affordable to provide them, the official insists.
Separately, don't hold your breath for the final physician Fee Schedule rule to remove the requirement for face-to-face physician visits before prescribing durable medical equipment. In the wake of the massive power wheelchair fraud in Texas and elsewhere, there's a major impetus to crack down on the dishonest docs and vendors. But the policy may change in 2006 if it seems too onerous and some items turn out not to need face-to-face visits.
The CMS official confirmed that Medicare has always paid for consults between members of the same specialty, as long as circumstances warrant. Besides the case of the gastroenterologist-cardiologist consult, there may be one doctor in a rural area who has a particular expertise from which a patient may benefit. Two doctors may share the same specialty, but a patient may have been admitted by the doctor who is less qualified to treat a particular problem.
"We're trusting physicians not to abuse this capability," the CMS official adds, stressing that the circumstances of covering same-specialty consults should be rare.
Separately, a regulation allowing all physicians, instead of a few specialties, to order power operated vehicles for their patients is in the final approval process and should be out soon, the official says.
Part B Insider (Multispecialty) Coding Alert
- Drug Payments:
Christmas May Come In November For Docs Who Dispense Drugs
But it's up to CMS to decide whether you get coal or candy
You could see [...] - Orthopedics:
New Knee Arthroscopy Codes Spark 'Sports Medicine' Debate
Many orthopedists welcome CPT's new knee surgery codes with open arms, but some regard them [...] - CMS Announces Demo Project For High-Cost Benes
The Centers for Medicare & Medicare Services wants to help the costliest Medicare patients obtain [...] - CPT 2005:
Some Doppler Studies Require Extra Work - And Now There Are Codes To Match
Start learning the difference between vasoreactivity and emboli detection
Neurologists will rejoice at three new codes [...] - Acupuncture Gains Codes, But Reimbursement Questions Persist
Medicare has always refused to pay for acupuncture (97780-97781) but CPT Codes 2005 deletes those [...] - Billing:
Don't Remain In The Dark On Billing Trends
A monthly report can make the difference between failure and success
Recently, Phyllis Yingling discovered a major [...] - Fee Schedule:
Let Docs Choose Level For 'Welcome to Medicare' Exam Codes, AMA Urges
With the Centers for Medicare & Medicaid Services planning to issue its final 2005 - Part B Coding Coach:
Keep Auditors Out With This Modifier -59 Checklist
You can avoid overusing -59 by simply consulting the CCI
If you [...] - Physician Notes:
CMS Official: 'Welcome to Medicare' Not A Problem For Most Docs
While many physician groups have become vocal in their belief that a level-three office visit [...]
