CMS Releases Emergency Update to 2010 Medicare Physician Fee

Conversion factor for 2010 is 36.0846.

http://www.cms.hhs.gov/transmittals/downloads/R1886CP.pdf

CMS 2010 Physician Fee Cuts Delayed

The U.S. Senate approved a $636 billion military appropriations bill on Dec. 19, 2010 delaying the cuts in the Medicare physician fees until March 2010. The bill includes a provision that delayed the Centers for Medicare & Medicaid Services (CMS) plans to reduce Medicare physician payments by 21.2 percent. Physician payments are frozen at 2009 levels through Feb. 28, 2010.

RAC Region C Issues DRG Validations

Connolly Healthcare, the Recovery Audit Contractor for Region C, posted new approved issues for DRG validations. These issues will be part of the complex medical review process that is being rolled out to Medicare providers.

http://www.connollyhealthcare.com/RAC/pages/approved_issues.aspx

Recent Updates Recovery Audit Contractor

Recent Updates Recovery Audit Contractor: "12/02/09: CMS Announces RAC DRG Validation ADR limits for FY 2010. These limits will apply to DRG Validation only. CMS will post the limits for all other reviews at a later date."

http://www.cms.hhs.gov/RAC/Downloads/DRGvalidationADRlimitforFY2010.pdf

Context4 Healthcare Newsletter

Context4 Healthcare's Newsletter focusing on UCR fees:


http://www.context4healthcare.com/pdf/Newsletter_November_December.pdf

Upcoming New or Changed UB-04 Billing Code(s) Effective 4/1/10

Type of Bill Code: 077x - Federal Qualified Health Center (FQHC)

This resolves the past issue where 073x was officially defined as "Clinical-Freestanding" but Medicare had it defined as "FQHC-Federal Qualified Health Center."

Revenue Codes:

086x Magnetoencephalography (MEG)
0860 General Classification
0861 MEG

This procedure was previously billed under Revenue Code 0740 EEG (Electroencephalogram). We have a question into the NUBC as to why there are two codes for what is basically one procedure; i.e. since there are no further subdivisions in this category, why do we have 0860 and 0861?

Also upcoming for 7/1/10: Changes and deletions in the "Point of Origin for Admission or Visit" codes and some new Condition, Occurrence and Value codes.

As the Context4 Healthcare products are updated biannually for 4/1/10 and 10/1/10, these changes will be included in the 4/1/10 updated data files with the effective date of 7/1/10 noted with the new/changed codes.

New Not-For-Profit Company Database for Out-of-Network Fee Rates

NY Attorney General announces reform of reimbursement system for Out-of-Network charges.


http://www.oag.state.ny.us/media_center/2009/oct/oct27a_09.html

Medicare Providers Have a New Competitor......Organized Crime

CNN reports on Organized Crime targeting Medicare and Medicaid:

www.cnn.com/2009/CRIME/10/22/medicare.organized.crime/index.html?eref=igoogle_cnn

Speak Now.......

NUCC seeks input on revisions to 1500 Claim Form

The National Uniform Claim Committee (NUCC) is currently seeking input on preliminary decisions it has made for potential changes to the 1500 claim form. These changes are based on the revisions in the 837 Professional Version 005010 transaction. The NUCC has made no final decisions on revising the 1500 claim form and is seeking public feedback. The comment period will end at the closed of business day on November 20, 2009.

NUCC Input Survey:
www.surveymonkey.com/s.aspx?sm=7Ll1WqF8Wj_2bECelTGGXjaQ_3d_3d

EMC Corporation Divested Assets

Context 4 Healthcare: "As of July 17, 2009, EMC Corporation has divested the assets associated with its healthcare data and coding product line-including ClaimsEditor®, CodeLink®, FirstPassTM, and other healthcare knowledge products-and transferred ownership to Naperville, IL based Context4 Healthcare, Inc."