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Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter
July 2008

MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)

MLN Matters Number: MM6087 Revised
Related Change Request (CR) #: 6087
Related CR Release Date: May 30, 2008
Effective Date: January 1, 2008, unless otherwise noted in CR6087
Related CR Transmittal #: R1528CP
Implementation Date: July 7, 2008


July Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)

 

Note: This article was revised on June 9, 2008, to correct the summary of CR6087 in the “Impact to You” section below. All other information remains the same.

 

Provider Types Affected
Physicians and providers who submit claims to Medicare carriers and Part A/B Medicare Administrative Contractors (A/B MAC) for services rendered to Medicare beneficiaries that are paid based on the MPFSDB

Provider Action Needed
Impact to You
Payment files for the MPFS were issued based on the 2008 Medicare Physician Fee Schedule Final Rule. Change Request (CR) 6087 amends those files AND includes new/revised codes for the Physician Quality Reporting Initiative (PQRI).

What You Need to Know
Physicians and providers may want to pay particular attention to the issue that effective July 1, 2008 payments are calculated using the conversion factor of $34.0682, update factor of 0.899 and without the work geographic adjustment, which is the previous payment methodology that was outlined in the 2008 MPFS Final Rule but was delayed as a result of the Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) Extension Act of 2007.

What You Need to Do
Make certain that your billing staffs are aware of these changes.

Background
Section 1848 (c)(4) of the Social Security Act provides for the establishment of the policies needed in order to implement relative values for physicians’ services. CR6087 is the official document that announces these changes in the Medicare schedule. Rather than duplicate all the additions, deletions and changes in this article, the Centers for Medicare & Medicaid Services (CMS) directs you to CR6087, which contains lengthy lists of these items. CR6087 is available at http://www.cms.hhs.gov/Transmittals/downloads/R1528CP.pdf on the CMS Web site.

As mentioned above, the key portions of CR6087 include the following information:
New G-codes for the Home Sleep Study Test Portable Monitor
New G-codes effective for services performed on or after March 13, 2008 are:

Code
Long Descriptor
Short Descriptor
G0398 Home sleep study test (HST) with type II portable monitor, unattended; minimum of seven channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort, and oxygen saturation. Home sleep test/type 2 Porta
G0399 Home sleep test (HST) with type III portable monitor, unattended; minimum of four channels: two respiratory movement/airflow, 1 ECG/heart rate and one oxygen saturation Home sleep test/type 3 Porta
G0400 Home sleep test (HST) with type IV portable monitor, unattended; minimum of three channels Home sleep test/type 4 Porta

New G-codes for the Physician Quality Reporting Initiative (PQRI)
Effective for dates of service on or after July 1, 2008, the following HCPCS codes will be added to the MPFSDB:

Code
Long Descriptor
Short Descriptor
G8485 Clinician intends to report the Diabetes measure group Report, Diabetes Measures
G8486 Clinician intends to report the Preventive Care measure group Report, Prev Care Measures
G8487 Clinician intends to report the Chronic Kidney Disease (CKD) measure group Report CKD Measures
G8488 Clinician intends to report the End Stage Renal Disease (ESRD) measure group Report ESRD Measures

New Category II Codes
Effective for dates of service on or after July 1, 2008, the following Category II Codes will be added to the MPFSDB. (These codes are not part of the Physician Quality Reporting Initiative for 2008.)

Code
Long Descriptor
Short Descriptor
3351F Negative screen for depressive symptoms as categorized by using a standardized depression screening/assessment tool Neg scrn dep symp by deptool
3352F No significant depressive symptoms as categorized by using a standardized depression assessment tool No sig dep symp by dep tool
3353F Mild to moderate depressive symptoms as categorized by using a standardized depression screening/assessment tool Mild-mod dep symp by deptool
3354F Clinically significant depressive symptoms as categorized by using a standardized depression screening/assessment tool Clin sig dep sym by dep tool

Please note that G-codes and CPT Category II codes are used to report quality measures under the PQRI program or for measure testing. The G-codes and CPT Category II codes applicable to the 2008 PQRI Measure Set are available in the “2008 PQRI Quality Measures Specification” document at http://www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp#TopOfPage on the CMS Web site.

New Category III Codes
Effective for dates of service on or after July 1, 2008, the following Category III Codes (0188T through 0192T) will be added to the MPFSDB:

Code
Long Descriptor
Short Descriptor
0188T Videoconferenced Critical Care First 30-74 Min Videoconf crit care 74 min
0189T Videoconferenced Critical Care Ea Addl 30 Min Videoconf crit care addl 30
0190T Intraocular Radiation Src Applicator Placement Place intraoc radiation src
0191T Ant Segment Insertion Drainage W/O Reservoir Int Insert ant segment drain int
0192T Ant Segment Insertion Drainage W/O Reservoir Ext Insert ant segment drain ext

Note that your carrier or MAC will not reprocess claims already paid prior to implementation of this update. However, if you bring such claims to your contractor’s attention, they will adjust such claims.

Additional Information
To see the official instruction (CR6087) issued to your Medicare carrier or A/B MAC visit http://www.cms.hhs.gov/Transmittals/downloads/R1528CP.pdf on the CMS Web site.

If you have questions, please contact your Medicare Carrier or A/B MAC at their toll-free number which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

 

Disclaimer This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

 

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