Jan 4, 2017 | Uncategorized
There are 8 new CPT codes to reflect epidural spinal injections. These new codes are classified by both anatomy and whether imaging guidance was used and replace codes 62310 – 62319.n
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- 62320 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
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- 62321 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)
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- 62322 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
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- 62323 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)
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- 62324 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
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- 62325 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)
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- 62326 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
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- 62327 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)
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Jan 4, 2017 | Uncategorized
Bunionectomy codes underwent expansion and revision in this year’s CPT update. Two new codes were added to reflect more accurate procedural options as well as many revisions to the technical descriptions of existing bunion correction codes.n
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- 28291 – Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant
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- 28295 – Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method
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Jan 4, 2017 | Uncategorized
The most significant changes this year for diagnostic and interventional radiology involve mammography bundling, ultrasound screenings for AAA, and fluoroscopy services. Fluoroscopy codes 77002-77003 are now subject to the global period concept and are designated add-on codes.nnMammography services now include computer – aided detection (CAD), which eliminated the add-on codes reported in previous years. CMS is still requiring the use of HCPCS G-codes and will not eliminate these codes until 2018.n
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- 77065 – Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral
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- 77066 – Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral
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- 77067 – Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed
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- G0202 – Screening mammography, producing direct digital image, bilateral, all views
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- G0204 – Diagnostic mammography, producing direct 2D digital image, bilateral, all views
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- G0206 – Diagnostic mammography, producing direct 2D digital image, unilateral, all views
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nA new code has been created to specifically screen for an abdominal aortic aneurysm. This CPT code will replace G0389, which has been used in previous years.n
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- 76706 – Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)
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Jan 4, 2017 | Uncategorized
At the end of the day, contracting in this day of pay–for–performance and adding value to the relationship is about the bottom line. What is the bottom line? The Spend!nnIn most states, including Colorado, the commercial health plans have to tell the state what their premiums are. Their premiums come from their estimate as to what their network and covered population will cost. I find it fascinating to look and see what the various payers are declaring! You can tell a lot about a network and its management by looking at these numbers.nnCan a provider help a payer lower its spend? Can you control costs? Not necessarily your own costs but the costs of those you refer to? You may be surprised!n
The bottom line, don’t give it (this ability) away!
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Stay tuned for more Todd’s Tips!
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment.
Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
Dec 13, 2016 | Uncategorized
Transition InformationnOn March 1, 2017, Hewlett Packard Enterprises (HPE) will assume fiscal agent operations on behalf of Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). These operations include the transition to the Colorado interChange (a new claims payment system) and a new provider Web Portal.nnYou must be enrolled in the new Colorado interChange. All providers must be enrolled (and approved) in the Colorado interChange system by March 1, 2017. Those who are not enrolled and approved will not be able to submit claims or receive payments. Visit Colorado.gov/HCPF/Provider-Enrollment for more information.nnAll ordering, prescribing, or referring (OPR) providers must be enrolled in the new Colorado interChange. The Affordable Care Act (ACA) now requires physicians and other eligible practitioners to enroll in the Medicaid program to order, prescribe, and refer items or services for Medicaid members, even when they do not submit claims to Medicaid. Claims listing an OPR provider that is not enrolled cannot be paid. Visit Colorado.gov/HCPF/OPR for more information.nnClearinghouse Enrollment & TestingnIf you utilize a Clearinghouse to submit batch claims or eligibility transactions, your Clearinghouse MUST apply for an interChange Trading Partner ID (TPID) and pass test transactions for HIPAA compliance. Clearinghouses without an interChange TPID will not be able to submit batch claims or receive reports beginning March 1, 2017.nnPlease check this list to see if your Clearinghouse has enrolled and passed testing. If your Clearinghouse has not started or has not completed their testing, we recommend that you reach out and remind them to do so immediately. Your Clearinghouse can learn more information about applying for a new TPID at: Colorado.gov/HCPF/EDI-support.nnContact UsnIf you need assistance with your revalidation or enrollment application, please call the Health First Colorado Enrollment and Revalidation Information Center at: 1-844-235-2387. Standard operating hours are 8am – 5pm MT, Monday – Friday.nnPlease Note: For billing, claims and Provider ID questions regarding the current Xerox system, please continue to call Xerox State Healthcare at: 1-800-237-0757.nnThis article originally posted on Colorado.gov.
Dec 13, 2016 | Uncategorized
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nThis article was originally posted on Healthleadersmedia.com.
