Coding Resource Center
January 2020
January 2, 2020 – The Centers for Medicare and Medicaid Services (CMS) re-issued the MLN Matters® Article SE18006 “to update certain language to show the use of MBI is fully implemented.” The MBI cards are to be used for all Medicare transactions and will identify beneficiaries without the use of social security numbers (SSNs). MBI […]
December 2019
December 23, 2019 – According the Centers for Medicare and Medicaid Services (CMS) Weekly Digest Bulletin, Medicare providers are required to submit claims for beneficiaries using Medicare Beneficiary Identifier (MBI) cards starting January 1, 2020. The MBI cards will identify beneficiaries without the use of social security numbers (SSNs), which offers better identity protection. This […]
December 2019
December 10, 2019 – The United States Preventive Services Task Force (USPSTF) is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. This group works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services. USPSTF published a final recommendation statement on screening for abdominal aortic […]
December 2019
The major code changes for 2020 are related to “Endovascular Repair of Abdominal Aorta and/or Iliac Arteries” section of CPT®: Deletion of Category III code 0254T Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, dissection) using bifurcated endograft from the common iliac artery into both the external and internal iliac artery, […]
November 2019
November 21, 2019 – In response to the CMS Change Request 10901, Novitas Solutions, Inc. has revised the Local Coverage Article (A53124) for billing and coding of endovascular repair of aortic and/or iliac aneurysms. This document specifies the CPT® codes included for TEVAR, EVAR and separately reportable services performed during the aneurysm repair; and coding […]
November 2019
The OPPS rate is a national unadjusted payment amount which include the Medicare and beneficiary payment. It is divided into a labor-related and nonlabor-related amount, and the labor-related amount is adjusted based on the locality in which the hospital is located. For CY 2020 CMS is: Updating OPPS payment rates for hospitals that meet applicable […]
November 1, 2019 – the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare Physician Fee Schedule (MFPS), Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgery Center (ASC). Highlights are described below. For MFPS: RVUs are converted to dollar amounts through the application of the conversion factor (CF). The […]
October 2019
October 25 – the AMA CPT® Editorial Panel released the September Meeting summary notes. The following are a few of the changes noted. The full summary can be found at https://www.ama-assn.org/system/files/2019-10/september-2019-summary-panel-actions.pdf. Of interest is the accepted parenthetical note revision in the EVAR section of the CPT® manual following code 34709 (Placement of extension prosthesis(es) distal to the common iliac […]
October 2019
October 17, 2019 – In response to the CMS Change Request 10901, Novitas Solutions, Inc. has revised the LCD (L35084) for Non-Coronary Vascular Stents. The entire coding section of the LCD has been removed and placed into a related Local Coverage Article (A56365). This document specifies the CPT® codes included, and the ICD-10-CM codes that […]
October 2019
On July 29, 2019, CMS issued a proposed rule that would update payment policies and rates under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services effective January 1, 2020. The ESRD PPS provides a patient-level and facility-level adjusted per treatment payment to the ESRD facilities for dialysis services, whether done in the facility or the […]
