Clinical Resources Articles
These sleep medicine articles include updates about coding and reimbursement, new practice guidelines, and telemedicine. To view our case study of the month, visit the AASM sleep medicine case studies page.
Recently, the four area DME MACs published draft Local Coverage Determinations (LCDs) addressing oral appliance therapy for obstructive sleep apnea. These four policies took effect Jan. 3, 2011.
Beginning in November 2010, the AASM sent out regular updates to members related to the 2011 Medicare Physician Fee Schedule (MPFS) Final Rule. To avoid confusion and help clarify payment changes, we have developed an overview of the MPFS Final Rule including a timeline of events, national payment information, instructions for finding local payment information and a glossary of key terms.
New legislation and recent corrections to the 2010 Medicare Physician Fee Schedule (MPFS) call for reprocessing of a large volume of Medicare fee-for-service claims. Given this large workload, the Centers for Medicare & Medicaid Services (CMS) is taking steps to ensure that new claims coming into the Medicare program are processed timely and accurately, even as the retroactive adjustments are being made.
Recently, four Medicare Part B Contractors – National Government Services, Palmetto, Highmark, and Wisconsin Physicians Service – revised local coverage determination (LCD) policies for sleep studies.
Effective Oct. 1, 2013, diagnostic coding in all health-care settings will change from ICD-9 to ICD-10. To accommodate the changes to the code structure resulting from this transition, CMS is requiring an update to the transaction standards used for electronic health-care claims. The current standards, Version 4010/4010A, must be upgraded to Version 5010 by Jan. 1, 2012.
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) notified the AASM that it will be establishing a Medicare physician specialty code for sleep medicine. The letter noted the important work that sleep medicine physicians provide for Medicare beneficiaries and stated that the request submitted by the AASM met all of the criteria for approval.
Effective Oct. 1, 2013, diagnostic coding in all health care settings will change from the International Classification of Diseases Ninth Revision (ICD-9) to the Tenth Revision (ICD-10). Hit the jump to learn the highlights the biggest differences between the ICD-9 and ICD-10.
The Centers for Medicare & Medicaid Services (CMS) has released a revision to the 2011 Physician Fee Schedule that adjusts calculations of the Medicare payment rates. The revision includes adjustments to the conversion factor and fees for services, including sleep medicine codes.
In an Emergency Update to the CY 2011 Medicare Physician Fee Schedule (MPFS) Database published Dec. 29, 2010, the Centers for Medicare & Medicaid Services (CMS) revised the conversion factor from the December 2010 rate of $36.8729 to a new rate of $33.9764 effective Jan. 1, 2011.
On Wednesday President Obama signed into law “The Medicare and Medicaid Extenders Act of 2010” (HR 4994), which will extend current Medicare reimbursement rates until Jan. 1, 2012.
The law prevents the scheduled reduction to the overall rate of physician reimbursement for services provided to Medicare beneficiaries. The conversion factor, one of the key elements of the Medicare payment formula, will remain at $36.87 for 2011.