Part B Insider (Multispecialty) Coding Alert
CMS Slashes More Than a Dozen Codes
CMS giveth, and CMS taketh away.
Some other procedures that hadn't seen any increases at all are nevertheless coming under the ax for alleged errors. CMS slashed the non-facility PE-RVU values for a total of 14 CPT Codes in Program Memorandum AB-03-070.
Also hard-hit was 67825 (Correction of trichiasis; epilation ...), which would drop from an average $252.84 to about $116.28. And 92081 (Visual field examination, unilateral or bilateral) dropped from $88.22 to about $45.95.
And Here's the Good News ...
CMS'program memo wasn't all bad news, however. A total of 11 codes had their PE-RVUs increased slightly or significantly. The biggest boost came to 94014 and 94015, codes created in 1999 to report spirometric measurements taken by a patient at home. The codes now reimburse an average of $55.14 and $29.77 respectively, up from $36.02 and $10.66 respectively in the past.
Also increased were 99235 (Observation) and 92250 (Fundus photography), with PE-RVUs of 2.69 and 1.55, up from 2.61 and 1.49.
At the start of 2003, the Centers for Medicare & Medicaid Services boosted the practice expense relative value units (PE-RVUs) for certain Medicare services, including Pap smears. But in July, those gains will disappear due to what CMS is calling an error in the Physician Fee Schedule database that it must fix.
The most dramatic drop hit 65220, for "removal of foreign body from eye," which sagged from 8.06 PE-RVUs to 3.50. According to the reimbursement calculator on Physician's Computer Company's Web site, the earlier PE-RVU would have spelled an average reimbursement of $322.39. With the new PE-RVU, the reimbursement will be $154.75.
As for Pap smears, G0124 and G0141 dropped from about $51.83 for both procedures to about $22.79, where they had been in 2002 before CMS increased the PE-RVUs in the first place. And G0219 (PETimaging, whole body; melanoma for non-covered indications) dropped from about $76.83 to about $56.61.
Ophthalmologists who lost out due to reductions in 65220 and 92081 will gain from an increase to 76519 (Ophthalmic biometry ... with IOL power calculation) from 1.86 PE-RVUs to 1.93. And 53853, for "transurethral destruction of prostate tissue; by water-induced thermotherapy," saw a slight increase from 38.50 to 38.96.
Part B Insider (Multispecialty) Coding Alert
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