Part B Insider (Multispecialty) Coding Alert

Published on Thu Nov 08, 2007 PDF

If you had trouble finding -Sengstaaken- in your medical dictionary, that's because it was a typo in CPT 2008.

The AMA has released its list of corrections to errors in CPT 2008, and the errors range from spelling mistakes (such as the misspelling of -Sengstaken- in the 43460 descriptor) to incorrect captions (for instance, the thoracentesis illustration that references 32421 should instead refer to 32422).

To read the full list of CPT 2008 corrections, visit the AMA's Web site at www.ama-assn.org/ama1/pub/upload/mm/362/08cptcorrections.pdf.

In other news:

Empire Medicare recently directed providers in Indiana and Kentucky to start requiring ABNs when performing acupuncture procedures described by 97810-97814. In its Medicare Monthly Review, Empire stated, -Previously, acupuncture was denied as a -noncovered- service. However, the correct denial for acupuncture is a medical necessity denial, and therefore, the physician must give the beneficiary an Advance Beneficiary Notice - The GA modifier should be reported on the claim with the procedure code to indicate that an ABN has been signed by the beneficiary. The GZ modifier should be reported on the claim with the procedure code to indicate that an ABN has not been signed by the beneficiary.-

CMS has updated its list of allowable telehealth services. Effective Jan. 1, you can report 96116 (Neurobehavioral status exam) for telehealth services, as long as you meet all of the eligibility criteria. Modifier GT describes telehealth services via interactive audio and video telecommunications systems, whereas modifier GQ refers to these services via an asynchronous telecommunications system. Visit http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5628.pdf for more on the new telehealth article.

If you-re billing Medicare for oxygen therapy, you may be getting a lot of questions from patients and providers lately. A Nov. 30 article in the New York Times, -Oxygen Suppliers Fight to Keep a Medicare Boon,- noted that Medicare pays significantly more for medically prescribed oxygen therapy delivered in the homes of Medicare beneficiaries than oxygen equipment provided by Internet suppliers to individuals. Many oxygen suppliers are balking at the article's tone, noting that their oxygen therapy involves just that--therapy--and not simply a filled oxygen tank, thus making their service a bit more costly than Web-ordered oxygen supplies.