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January 25, 2018

Four Tests Added to List of CLIA Waived Tests

In early January, the Centers for Medicare and Medicaid Services (CMS) announced new waived tests... Learn More

New and Revised Vaccine Codes Added to 2018 CPT Code Book

The American Medical Association (AMA) added and revised several vaccine CPT codes for its 201... Learn More

OIG Recommends Measures for Curbing Opioid Misuse and Fraud

Office of Inspector General testimony before the House Committee on Ways and Means in January ... Learn More

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Medical Coding News Archives

CMS Recognizes Two New Specialty Designations

February 4, 2011:

Medicare physician specialty codes allow CMS to determine the types of services and procedures that a particular physician specialty performs. CMS also uses, specialty codes for programmatic and claims processing purposes as well as expenditure analysis, such as determining the drivers of growth under the sustainable growth rate (SGR). The SGR is an integral part of the formula used to determine revisions to the conversion factor used in the Medicare physician fee schedule (MPFS).

Individual Medicare contractors use specialty code data to develop claims processing edits to help identify potentially duplicative care provided by members of the same specialty. For these reasons, it is particularly important that providers indicate the correct specialty designation when completing their Medicare enrollment application.


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