Tag Archives: Insider
93224-93227 Take on Extra Jobs in 2011 to Make Up for Code Deletions
12, 24, and 48 hour services all have roles in this coding shake-up.
Cardiology codes are always changing, trying to keep pace with technology and current practice. For this reason, Holter monitor codes saw big changes this year. Here’s what you need to know.
Start With a Nutshell Holter Service Description
Dynamic electrocardiography (ECG), also called Holter monitoring, involves ECG recording, usually over 24 hours. The goal is to obtain and analyze a record of the patient’s ECG activity during a typical day. The medical record usually will include the reason for the test, copies of ECG strips showing abnormalities or symptomatic episodes, the patient’s diary of symptoms, statistics for abnormal episodes, the physician’s interpretation, and documentation of recording times.
Understand Your Newly Reduced Coding Options
In 2010, you chose among the following code ranges for these services:
- 93224-93227, Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage, with visual superimposition scanning
- 93230-93233, Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous original waveform recording and storage without superimposition scanning utilizing a device capable of producing a full miniaturized printout
- 93235-93237, Wearable electrocardiographic rhythm derived monitoring for 24 hours by continuous computerized monitoring and non-continuous recording, and real-time data analysis using a device capable of producing intermittent full-sized waveform tracings, possibly patient activated
In 2011, your coding options have changed. A new note under 93229 tells you “93230-93237 have been deleted. To report external electrocardiographic rhythm derived monitoring for up to 48 hours, see 93224-93227.” CPT® Changes 2011: An Insider’s View states that 93224-93227 have been revised to accommodate reporting the services described by 93230-93233 and 93235-93237.
Result:…
One Medicare Contractor OK’s RNs and LPNs to Furnish Annual Wellness Visit
CMS staffers confirmed this week that MACs can determine whether they’ll allow licensed practical nurses (LPNs) and registered nurses (RNs) to perform annual wellness visits (AWVs) and collect from Medicare for those services. That’s the word from a Feb. 22 CMS Open Door Forum, where providers called in with several questions affecting Part B providers.
One caller phoned into the forum to ask about a Q&A posted on the Web site of WPS Medicare, a Part B payer in four states, which asks whether an RN or LPN can perform “the entire annual wellness visit (AWV, G0438-G0439).” WPS responds on the site, “Yes, an RN or LPN can perform the visit. They need to be under the direct supervision of a physician and the state license needs to allow for them to do all the ocmpoennts of the service.” (http://www.wpsmedicare.com/part_b/education/awv-faq.shtml). The caller asked whether this is a general CMS policy or if it only applies to WPS Medicare.
“Remember, the LPN’s not billing,” said CMS’s William Rogers, MD, reminding the caller that the visit would be billed under the physician’s NPI as “incident to.” But the caller still considered it “odd” that an LPN could perform an AWV, since it’s similar to an E/M service.
“It’s a different sort of service – there’s not really any clinical judgment involved,” Rogers said. “It’s a service which includes a lot of sort of administrative steps, verifying that people have certain preventive services done and things like that, and so it is intended to be a collaborative service.”
Keep in mind that CMS does not have a national policy allowing LPNs and RNs to perform AWVs, but reps from the agency confirmed that it’s within the rights of the individual MACs to make this determination.
For more on this story,…
Replace 90658 With a Q Code, After Jan. 1
Get ready to change your flu vaccine product code 90658 to one of four Q codes.
For 2010, report 90658 (Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use) to signify that your physici… Continue reading
Congress Boosts Conversion Factor Through Dec. 31
Medicare Physician Fee Schedule rate won’t be cut 23 percent.
Although the government appeared poised to take a big bite out of your next Medicare Part B payments, you now have another month before you need to worry about losing pay. That’s because… Continue reading
CMS Slashes Conversion Factor for 2011, Establishes Preventive Visit Codes
Get ready for another year of nail-biting to find out if your Medicare payments will be slashed. “The calendar year 2011 Physician Fee Schedule conversion factor is $25.5217,” notes the 2011 Medicare Physician Fee Schedule Final Rule, printed in th… Continue reading
Handle Your Hand, Wrist Diagnoses With Care by Pinpointing Anatomic Site
Here’s how to differentiate the tiquetrum from the trapezium.
Doctors dealing with hand procedures don’t only treat carpal tunnel syndrome, and it’s up to you to link the correct diagnosis to the upper-extremity repair codes.
Use this anatomic dr… Continue reading
Place-of-Service Codes Caused $13 Million in Overpayments
Double check POS 11 shouldn’t be 22 — or 24.
Entering your place-of-service (POS) number on your claim form may seem routine, but a recent OIG audit found that practices are not giving POS numbers the care they deserve.
Based on a r… Continue reading
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