Macs Vary On Response To Cms' Cardiology Payment Adjustments

By Author: Nancy Rose
Total Articles: 53
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Do not look for a raise as yet, in most cases.


CMS may talk, however MACs do not always listen - at least not so quickly.


As was told to you in a recent Insider, CMS recently rectified several ‘technical errors' published in the 2010 Fee Schedule, and owing to these corrections, Medicare will increase payment for various cardiology-related testing codes, inclusive of codes 75571-75574 (Heart CT) and 78451-78454 (Heart muscle SPECT imaging).


Even though many practices are keen to see the payment boosts in their next Medicare payments that may be an overly ambitious goal at this juncture.


Says Terry Fletcher, BS, CPC, CCS-P, CCS, CMSCS, CCC, CEMS, CMS, CEO of Terry Fletcher Consulting Inc, I inquired with a few MAC carriers like Trailblazer, Noridian, and Palmetto and was told different things by different Medicare payers."


She adds, One didn't even know there was a change." Then, Noridian said ...
... that they'll be making the adjustments when they get the directive from CMS. What's more, Palmetto said they would require the provider to contact them and then batch retroactive to January the myocardial perfusion imaging (MFI) claims and send a letter to request the boost," she says.


The bottom line is: Until CMS provides a clear answer to the MACs regarding when they must make these changes, you may not see your pay hike; however keep an eye on your carrier's web site on when it purposes to reprocess claims making use of the new rates.


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