CMS is proposing two major changes as part of the 2013 OPPS proposed rule, released July 6. One has to do with how CMS proposes to calculate APC relative weights; the other addresses the reimbursement level for separately payable drugs and biologicals without pass-through status.
Betty B. Bibbins has a message for any healthcare professional-including HIM managers and directors-who struggles to get physicians to document with enough specificity to produce compliant coding and billing: It's your job to tell them how to do it better.
In this month's issue, our coding experts answer questions about how to differentiate between modifiers -52, -73, -74, coding for negative pressure wound therapy, and billing the technical component of pathology services.
Coding for physician services doesn’t always match coding for facility services, which can cause problems for coders who code records for both. ED E/M is one area where different rules come into play.
HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable]) will once again meet the criteria to override the device-to-procedure edit for CPT® code 33249 (insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead[s], single or dual chamber).
