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March 27, 2018


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Medical Coding News Archives

CMS Releases April Update to MPFS

 
March 10, 2009:

The Centers for Medicare and Medicaid Services (CMS) has released the April update to the Medicare physician fee schedule. These revisions go into effect April 1.

Unlike most updates, this one also contains a bit of coding guidance. In the 2009 MPFS final rule, CMS indicated that the newly created CPT code 95992 Canalith repositioning procedure(s) (e.g., Epley maneuver, Semont maneuver), per day, was previously billed by physicians as part of an evaluation and management (E/M)service, and by nonphysician practitioners, primarily therapists, using other existing codes. CMS therefore assigned the code a status indicator of B (bundled), and stated that bundling this code is most appropriate because this service is currently being paid for as part of an E/M service. Since this service is also billed by nonphysician providers who cannot bill an E/M service, CMS has indicated in the fee schedule update that therapists should use code 97112 when billing for this service.

Other revisions of note include the following:

  • The procedure status of the following codes has been changed to M, measurement code. For reporting purposes only. These codes are the category II codes that are used to report the quality measures.    
  • 0529F
    0 540F
    1170F
    3016F
    3250F
    3455F
    3470F
    3471F
    3472F
    3475F
    3476F
    3570F
    4148F
    4149F
    4192F
    4193F
    4194F
    4195F
    4196F
    4267F
    G8489
    G8490
    G8491
    G8492
    G8493
    G8494
  • The procedure status of the codes below has been changed to I, Not valid for Medicare purposes. This indicates that these codes are NOT valid for Medicare and that another code is used for reporting these services to Medicare. It should be noted that other non-Medicare payers may accept these codes. 
  • 0575F 
    4270F 
    4271F 
    4279F 
    4280F 

  • The procedure status of the codes below has changed to E, Excluded from physician fee schedule by regulation. No relative value units (RVUs) are assigned to these services, and no payment may be made under the fee schedule for these codes.
  • J7611
    J7612
    J7613
    J7614

  • A number of services had RVUs revised:
  • G0270 Work RVU = 0.45
    G0392 Transitional facility PE RVU = 3.60
    G0393 Transitional facility PE RVU = 2.36
    G9041 Work RVU = 0.54
    Transitional nonfacility PE RVU = 0.22
    Fully implemented nonfacility PE RVU = 0.22
    Transitional facility PE RVU = 0.22
    Fully implemented facility PE RVU = 0.22
    G9042 Work RVU = 0.20
    Transitional nonfacility PE RVU = 0.20
    Fully implemented nonfacility PE RVU = 0.20
    Transitional facility PE RVU = 0.20
    Fully implemented facility PE RVU = 0.20
    G9043 Work RVU = 0.20
    Transitional non-facility PE RVU = 0.20
    Fully implemented nonfacility PE RVU = 0.20
    Transitional facility PE RVU = 0.20
    Fully implemented facility PE RVU = 0.20
    G9044 Work RVU = 0.19
    Transitional non-facility PE RVU = 0.15
    Fully implemented nonfacility PE RVU = 0.15
    Transitional facility PE RVU = 0.15
    Fully implemented facility PE RVU = 0.15

Deborah C. Hall
Clinical/Technical Editor

 

 
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