Untitled Page
New and revised ABN modifiers
CMS release....
Deductibles and premiums go up in 2010

In the October 22 2009, Federal Regis....
more
Your Name
Email Id
Thursday, February 25, 2010
New and revised ABN modifiers
CMS released a transmittal announcing a new and a revised modifier for use with advance beneficiary notices ABNs.  The GA modifier definition is changing as illustrated below:
GA – Waiver of liability statement on file (old definition)
GA – Waiver of Liability Statement Issued, as Required by Payer Policy (new definition)Before the Notice of Exclusion of Medicare Benefits’ (NEMB) elimination, it served as an optional courtesy notice; explaining that excluded services (i.e., plastic surgery) is uncovered. Providers now use the ABN for this purpose. Report the GX modifier when the patient receives an ABN even though the patient would be liable without one.
GX – Notice of liability issued, voluntary under payer policy
Effective date:  April 1, 2010
Implementation date:  April 5, 2010
Thursday, February 25, 2010
Deductibles and premiums go up in 2010

In the October 22 2009, Federal Register, CMS announced the new Part B deductible and monthly premium amounts for 2010. The annual deductible will increase from $135 to $155 for all beneficiaries. The standard monthly premium will increase to $110.50 from $96.40 for 2009. CMS adjusts premiums based on beneficiary income, so some beneficiaries pay a higher rate than the standard.

CMS announced the CY2010 Medicare Part A deductible for inpatient hospital services. When a patient is admitted as an inpatient, the deductible will increase from $1,068 in 2009 to $1,100 in 2010. In addition, beneficiaries will pay an additional daily coinsurance of $275 for days 61 through 90 and $550 for lifetime reserve days. For 2009, the corresponding amounts are $267 and $534, respectively.
Thursday, February 25, 2010
CMS Consult Codes Cross-Walk
Consultation codes are no longer valid for Medicare claims.
Consultation service codes may not be billed to Medicare for services rendered on or after January 1, 2010. Physicians must use visit/outpatient or inpatient hospital evaluation and management codes to bill Medicare for consultation services. Telehealth consultation may be reported using the appropriate HCPCS G-codes.

CMS published a cross-walk from consultation codes to outpatient/hospital codes for the purpose of establishing budget neutrality. According to CMS the cross-walks are not billing guidance and physicians should bill the E/M code appropriate for the service provided.

For office based consultations, the selection of E/M visit codes is based on whether the patient is a new or established patient. For hospital consultations, the selection of appropriate E/M codes is based on the location of the consultation in either an acute care hospital or nursing home and the level of history, exam, and medical decision making.
Thursday, February 25, 2010
New J-code for Taxotere Injection Concentrate

In its annual update to the Healthcare Common Procedure Coding System (HCPCS) for 2010, the Centers for Medicare and Medicaid Services (CMS) assigned a new HCPCS billing code and unit to Taxotere for dates of service on or after January 1, 2010.

This change applies to all payers. Medicare contractors will be required to accept this new code on January 1, 2010; other payers, including private payers and Medicaid programs, may update their systems on an alternate schedule.
J9171 (docetaxel, injection, per 1 mg) should replace J9170 (docetaxel, injection, per 20 mg). The retired J9170 code and 20-mg billing unit should not be used on or after January 1, 2010.
 
Usename
 
Password
Register | Forgot Password
Physicians Groups
   
Hospitals
   
Billing Companies
   
Insurance Companies
   
Copyright A-One Biz