Pathology/Lab Coding Alert

Error warrants small adjustment.

 If you weren’t paying close attention, you might have missed the recent CMS announcement of a $0.02 adjustment to the 2016 Medicare Physician Fee Schedule (MPFS) conversion factor (CF).

That means the multiplier your payers apply to procedure relative value units (RVUs) to come up with your actual pay just got smaller. The CF is now 35.8043, down from the 35.8279 published in the 2016 MPFS final rule in November 2015.

Why the change? Apparently, CMS made errors in the blending of 2014 utilization data that impacted the practice expense and professional liability insurance inputs for several codes says Michael A Granovsky, MD, FACEP, CPC, president of LogixHealth, a national coding and billing company based in Bedford, Mass.

Bottom line: It’s not much, but you may wish to recalculate your Medicare payments for 2016 using the updated CF.