Cardiac computed tomography (CCT) professionals will see major changes in coding next year. CPT® 2010 adds four new Category I codes to report CCT and cardiac computed tomography angiography (CCTA) services and deletes four Category III codes.

In a statement posted on its Web site prior to the Oct. 30 release of the 2010 Outpatient Prospective Payment System (OPPS) final rule, the Society of Cardiovascular Computed Tomography (SCCT) said it did not foresee significant changes in payment for CCT/CCTA. They were singing another tune Nov. 2.

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Hospitals who successfully participated in quality data reporting for outpatient services will receive a 2.1 percent inflation update in their 2010 payment rates for services furnished to Medicare beneficiaries in outpatient departments, according to the Centers for Medicare & Medicaid Services (CMS). Ambulatory surgical centers (ASCs) will receive a 1.2 percent inflation update beginning Jan. 1, 2010 using the same payment methodology as in 2009.

These and other payment and policy changes can be found in the 2010 Hospital Outpatient Prospective Payment System (OPPS) and ASC final rule with comment period — put on display for review Oct. 30.

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The 46 percent cut in single photon emission computed tomography (SPECT) reimbursement and 22 percent inrease in positron emission tomography (PET) reimbursement the Centers for Medicare & Medicaid Services (CMS) is proposing for 2010 has some speculating a significant rise in demand for cardiac PET in the coming years. Read more »

HCPCS Level II code Q2024 Bevacizumab injection will be reimbursed by Medicare effective October 1. Distributed under the trade name Avastin, the drug inhibits angiogenesis — the uncontrolled spread of blood vessels feeding cancer tumors and diabetic retinal proliferation in the eye.

To help you code this drug, which is often administered in concert with a chemotherapeutic drug, the code’s status indicator is “E,” which means Bevacizumab is excluded from the Medicare Physician Fee Schedule Data Base (MPFSDB) by regulation and has no relative value listed, but is paid under reasonable charge procedures. Type of service (TOS) codes are “1″ (Medical Care) and “P” (lump sum purchase of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies or DMEPOS).

Read the Centers for Medicare & Medicaid Services (CMS) Transmittal 1805 to learn more.

A minor software problem resulted in the non-transmittal of some public comments on two proposed rules submitted between July 26-30 via www.regulations.gov.

The problem has been corrected and the Centers for Medicare & Medicaid Services (CMS) is requesting the public resubmit their comments on the 2010 Physician Fee Schedule or 2010 Hospital Outpatient Prospective Payment System/Ambulatory Surgical Center Payment System proposed rule before the close of the comment period for these rules (Aug. 31, 2009).

Click here for information on how to resubmit public comment on either of these two proposed rules.

According to the American Association of Diabetes Educators (AADE), the U.S. House of Representatives has inserted language into its health care reform designating certified diabetes educators (CDEs®) as Medicare providers for outpatient diabetes self-management training (DSMT). Read more »

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced June 29 that the administration will rescind all or part of three Medicaid regulations and delay the enforcement of a fourth regulation.

Secretary Sebelius said the actions “are necessary to ensure that the states have the flexibility they need to fully serve Medicaid-eligible individuals.”

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The Centers for Medicare & Medicaid Services (CMS) proposed, July 1, several policy and payment rate changes for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) for fiscal year 2010. Payment rate increases for providers paid under the Outpatient Prospective Payment System (OPPS) and expanded coverage for certain Medicare services furnished in HOPDs and ASCs are projected in the 2010 proposed rule. Read more »

A proposed rule that addresses Part B payment policies paid under the Medicare Physician Fee Schedule (MPFS) went on display today in the Federal Register. The proposed rule with comment period includes several policy changes intended to help offset a much-anticipated payment cut in 2010.

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Wisconsin’s 60 ambulatory surgical centers (ASCs) may soon incur a tax that would raise state revenue $44 million over two years, Outpatient Surgery reports in its June 2 e-weekly newsletter.

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