Part B Insider (Multispecialty) Coding Alert

Plus: CMS halts coverage for vacuum erection devices.

Most practices are quite aware of the fact that Medicare beneficiaries hate seeing their Social Security Number (SSN) printed right on their Medicare identification cards—but that’s about to change. Due to the risk of identity theft, CMS will discontinue printing SSNs on beneficiary cards within the next four years. 

Last month, the Insider noted that the OIG’s Deputy Inspector General Gary Cantrell testified before Congress about Medicare fraud, and recommended removing SSNs from the documents to curb the growing problem of medical identity theft. Fortunately, Congress took note and included language in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that will eliminate the problem.

“The Secretary of Health and Human Services, in consultation with the Commissioner of Social Security, shall establish cost-effective procedures to ensure that a Social Security account number (or derivative thereof) is not displayed, coded, or embedded on the Medicare issued to an individual who is entitled to benefits under Part A of title XVIII or enrolled under Part B of title XVIII and that any other identifier displayed on such card is not identifiable as a Social Security account number,” the bill says.

The bill goes on to say that the agencies have four years to make the transition to SSN-free cards. 

In other news…

The power of the pen appears to be alive and well. After many media outlets complained about CMS’s coverage of vacuum erection devices (HCPCS code L7900), Congress took action to discontinue payment for these devices.

Background: The fervor over coverage for vacuum erection systems (VES) took hold in Dec. 2013 when the OIG testified that Medicare payments for these devices were “grossly excessive” compared with what non-Medicare payers and the general public pay for them. The OIG report brought to light the fact that Medicare was paying for men to get VES devices, which many media outlets took up as a top story. Several of these reports opined that it was wasteful and should be considered non-covered due to being used for “elective” purposes.

New policy: The days of VES payments will soon be over. Effective July 1, 2015, CMS will “prohibit payment on claims for VES prosthetic devices” with codes L7900 and L7902 (Tension ring, for vacuum erection device, any type, replacement only, each), the agency says in MLN Matters article SE1511. Therefore, you can expect denials for these devices for any dates of service on or after July 1.

Resource: To read the MLN Matters article, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1511.pdf.

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