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
 
07/10/17 | New Category III codes effective Jan 1st, 2018
 

You will want to update your bone marrow aspiration coding for 2018 as well as some adipose-derived cell therapy for hands

New Category III codes effective Jan 1st, 2018
 
07/10/17 | Spinal surgery
 

If you do any spinal surgery you want to be aware of the Medicare changes that are taking place regarding number of levels, number of cages as well as diagnosis issues.

Spinal surgery
 
06/10/16 | CMS starting to list ICD-10s not covered
  Unspecified ICD-10 codes be careful
CMS starting to list ICD-10s not covered
 
07/09/15 | Total joint issues from CMS
  Total joint issues from CMS
Total joint issues from CMS
 
12/31/14 | Holding claims and fee schedule issues for 2015
  Medicare wants claims held starting Jan 1, 2015
Holding claims and fee schedule issues for 2015
 
08/20/14 | Medicare finally catching on that modifier 59 is not enough
 
Medicare finally catching on that modifier 59 is not enough
 
07/22/14 | Keep an eye on your private payer contracts..
 
Keep an eye on your private payer contracts..
 
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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