On May 7, Medicare finally released the transmittals which summarize the basic rules for documentation, coding and billing of outpatient pulmonary rehabilitation (OPR) services. Multiple updates to the Medicare manuals were provided via two CMS transmittals – 124 (CR 6823) and 1966 (CR 6823) which describe the national coverage guidelines for OPR. 

“Billing for services while operating in an environment of audit” has become my favorite catch phrase for 2010. It has been just over 7 years since the AMA updated the CPT descriptions for hematology procedures adapting the codes to current reporting practice of the clinical laboratory. Still in 2010, one of the most frequently billed outpatient tests continues to be incorrectly or inappropriately reported for reimbursement.

The Centers for Medicare and Medicaid Services made it easier this year to collect a bonus for Electronic Prescribing. For certain ambulatory services, CMS now requires only one “G” measure code to be submitted on a claim. The measure is required to be reported on only 25 claims for the reporting period to be eligible for the 2% bonus. This is much easier than last year, when CMS required that one of three measure codes be submitted on 50% of eligible claims.