2010 Medicare Updates/Insurance News
- Congress Passes Reimbursement Extension for 2011 - (12/9/10);
UPDATE: President Obama signed the legislation (H.R. 4994) on 12/15/10
- CMS PECOS Enrollment Update Reminder - From Dr. Mark Block, Insurance Chairman, FPMA (11/1/10)
- To access the Medicare Physician Guide, go to http://www.cms.gov/MLNProducts/downloads/physicianguide.pdf. Please note that this is a very large PDF document and may take some time to access. (10/21/10)
- To find out more about Health Policy Issues, go to the Health Policy and Practice Page on the APMA members' website at http://www.apma.org/Members/hpp (10/21/10)
- To find out about another short-term payment fix anticipated for Medicare, go to the Medicare Payment Update Page on the APMA members' website at http://www.apma.org/Members/Advocacy/FederalResourceCenter/Legislative-Updates.aspx (10/21/10)
- To find out more about Medicare & Medicaid Electronic Health Record (EHR) Incentive Programs, go to the Centers for Medicare & Medicaid Services (CMS) website at http://www.cms.gov/EHRIncentivePrograms/ (8/18/10)
- To access a Health Care Reform Update provided by FPMA Insurance Services, go to http://www.fdaservices.com/shared/FPMA/news/fpma.htm (8/3/10)
- To access current information about Congress and Medicare fees, go to the FPMA eAdvocacy website at http://capwiz.com/apma/fl/home/
- PECOS Clarification - From Dr. Mark Block, Insurance Chairman, FPMA (3/2/10)
- PECOS Update, Attachment - From Dr. Mark Block, Insurance Chairman, FPMA (2/25/10)
- Update on SNF Initial Visit Codes (2/4/10)
I just received notice from FCSO that the SNF codes for initial visits 99304 - 99306 are officially open for podiatrists to use. Anyone holding claims for nursing home consultations should bill the initial visit codes. If you have previously billed, in 2010, 99034 and been denied you will need to resubmit or appeal.
Stephen Meritt, DPM
- Information About SNF Initial Visit Codes (1/27/10)
With the deletion of consultation codes, the rules have changed relative to the use of initial inpatient hospital and initial nursing facility codes. As in the inpatient hospital setting, the principal physician of record in the skilled nursing facility setting bills the initial visit code (99304-99306) and appends the AI modifier to identify himself/herself as the physician overseeing the patient's care. All other physicians, including podiatric physicians, report their initial visit to the patient with the initial visit code.
Section 30.6.13 A. of Chapter 12 in Pub. 100-04 (Medicare Claims Processing Manual) has been revised to state:
"The initial visit in a SNF and NF must be performed by the physician except as otherwise permitted (42 CFR 483.40 [c] ). The principal physician of record must append the modifier "-XX," Principal Physician of Record, to the initial nursing facility care code. This modifier will identify the physician who oversees the patient's care from other physicians who may be furnishing specialty care. All other physicians who perform an initial evaluation in the nursing facility may bill the initial nursing facility care code..."
ADDENDUM: First Coast Service Options is trying to open the SNF initial visit codes this week, but they may not be open for us yet. I would suggest that everyone hold SNF initial visit claims for 2 to 3 weeks and then submit them.
Stephen Meritt, DPM