November Update: HCPCS and BETOS updates have been included in the HCPCS & CPT Pre-release Codebook! Check daily e-mail updates for the changes report, the download center for a much easier to use HCPCS data file than the one CMS publishes, and the bottom of the codebook for a series of very helpful index files.

As part of the initial implementation of the PR program January 1, 2010, CMS recently issued Transmittal 124 (May 7^th 2010) within the Medicare Benefit Policy Manual clarifying medical necessity along with program specifications and supervision requirements. As many of the new preventative services offered by CMS, the goal of the program is patient awareness and education to facilitate more aggressive self care. 

CMS issues its changes to the Physician Fee Schedule quarterly, but how often do you have the chance to analyze it and review it? With over 15000 lines filling a spreadsheet, comparing each quarter’s changes can be a daunting and time consuming task. Are you aware that MediRegs does this for you? They issue a difference report every quarter that highlights the changes between the current version and the last quarter’s version. Look for the file called “Difference Report” and “MediRegs created.”

The 2010 HCPCS Level II update is now available in CCH Coding Comply. The updated data files became available on CMS’ website late Monday Night. It is anticipated that this update will be released in the HCPCS and CPT electronic code book in the Coding Suite and RRS sometime next week. When complete, a link will be provided in the “Hot Topics” box on the Welcome page of the Coding Suite.

On July 1, the CMS released the proposed changes to the Medicare Physician Fee Schedule (MPFS). CMS updates the MPFS annually to set payment rates for physician and non-physician practitioner services. The press release is found on the Medical Release Database section within CMS: http://tinyurl.com/kqsdym.

CMS recently released the Physician Fee Schedule code set update in conjunction with the Physician Fee Schedule Final rule, which was published in the Federal Register on November 19, 2008. This code set update becomes effective January 1, 2009.

This code set update includes several new surgical laparoscopy procedures (49652-49657) and stereotactic radiosurgery procedures (61796-61800) and modified skin debridement and benign lesion excision procedures with updated payment rates and RVU values (11004-11012 and 11404, 11406, 11420-11426, respectively).