02/28/19 | Great article on the issues with 63047 and 22633 and 22630

Find out about the issues between 22633/22630 and 63047 and get the history of these codes.  Great information you can use for your private payer appeals.

Great article on the issues with 63047 and 22633 and 22630
01/02/19 | Accessing Newsletters

How to get newsletters

Accessing Newsletters
01/02/19 | Calendar events

Calendar events

Calendar events
09/26/18 | Scam audio flyer Fionexia - please don't sign up

It has come to my attention that there is a flyer (from Fionexia) that is going out from a company that is fraudualent and stating I am doing an audio for them.  Please do not sign up it is a scam.  The audio they are advertising was done for AudioEducator.com. It appears if you pay for it you may not get anything for your pay!!!

Scam audio flyer Fionexia - please don't sign up
08/11/18 | Margie Vaught Newsletters

Now you can access and download the newsletters directly from this site. 

Margie Vaught Newsletters
07/20/18 | 2019 Proposed Fee schedule released

Proposed 2019 Fee Schedule is out – hang on to your seats…

CMS released the 12th of July the proposed changed for the physician fee schedule for 2019 (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-07-12.html).

2019 Proposed Fee schedule released
07/20/18 | CPT updates policy of 63047 with 22633

CPT updates their policy regarding nerve root decompressions and interbody fusions

AANS, NASS and AAOS have been working hard on getting CPT to change their previous October 2016 CPT Assistant regarding nerve root decompression 63047 and interbody fusion 22633 being inclusive

CPT updates policy of 63047 with 22633
03/05/18 | Total knee arthroplasty (27447) removed from Inpatient only list – causing confusion

You may have been experiencing feedback from a facility when trying to schedule your total knee replacements as inpatients. 

Total knee arthroplasty (27447) removed from Inpatient only list – causing confusion
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Better start checking with your local medicare carrier to see if  they following what Florida is doing:

New LCD in Florida Requires Greater Documentation for Major Joint Replacement

First Coast Service Options will implement a new Local Coverage Determination for Major Joint Replacement on October 16, 2011. The LCD will require physicians to enhance documentation of conservative treatment and indications to support the medical necessity of total hip and total joint replacements in the hospital record in addition to the office based patient record.

The basis of this LCD is the Comprehensive Error Rate Testing (CERT) audits that have called into question the medical necessity of some of these procedures when auditing in-patient hospital records. Due to a lack of documentation of conservative therapy and indications for surgery in some instances the audits have resulted in requests for the hospital and physicians to return compensation for those procedures.

The LCD will require physicians to enhance the documentation they provide in the hospital records. FOS members need to adhere to this LCD to protect their reimbursements.

The FOS worked directly with the AAOS, the Hip and Knee Societies, AAHKS, and First Coast Service Options to make significant changes to the initial proposal. We are pleased that FCSO did make many of the changes that we requested. We do need to hear from you if you discover any issues with the LCD once implemented.

A copy of the Final LCD in effect October 16th is Download Major Joint Replacement LCD Final Version FCSO Full Version.

Also Trailblazers has also weighed in http://www.trailblazerhealth.com/Tools/Notices.aspx?DomainID=1&ID=14756