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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Musculoskeletal Global Surgery Fees Often Did Not Reflect the Number of Evaluation and Management Services Provided (A-05-09-00053) http://go.usa.gov/Vyz

Musculoskeletal global surgery fees often did not reflect the actual number of evaluation and management (E&M) services that physicians provided to beneficiaries during the global surgery periods. Using our sample results, we estimated that Medicare paid a net $49 million for E&M services that were included in musculoskeletal global surgery fees but not provided during the global surgery periods in 2007. Global surgery fees include payment for a surgical service and the related preoperative and postoperative E&M services provided during the global surgery period. The global period for major surgeries includes the day before the surgery, the day of the surgery, and the 90 days after the day of the surgery.

For 211 of the 300 sampled global surgeries, the fees did not reflect the actual number of E&M services provided. Specifically, physicians provided fewer E&M services than were included in 165 global surgery fees and provided more E&M services than were included in 46 global surgery fees. For the remaining 89 global surgeries that we sampled, either the fees reflected the actual number of E&M services provided during the global surgery periods (24 surgeries) or the surgery was 1 of multiple surgeries (65 surgeries). (For the 65 sampled surgeries that were performed as 1 of multiple surgeries, we were unable to determine whether the E&M services that physicians provided were related to the sampled surgeries or to 1 of the other surgeries performed on the same date of service. Therefore, we did not categorize these 65 sampled surgeries as errors.)

We recommended that CMS adjust the estimated number of E&M services within musculoskeletal global surgery fees to reflect the actual number of E&M services being provided to beneficiaries, which would have reduced payments in 2007 alone by an estimated $49 million, or use the results of this audit during the annual update of the physician fee schedule. CMS concurred, in part, with the recommendations but planned to conduct further analysis before proposing any changes in the number of E&M services assigned to musculoskeletal surgeries."