MEDICARE PROPOSES NEW RULES - EHR

Pending changes to Medicare payment rules will soon impact practitioners. Proposed updates include the deletion of biopsy codes, the revaluation of significant urology codes and the elimination of 10-/90-day global periods.

The Centers for Medicare & Medicaid Services recently proposed a number of changes to Medicare payment rules, which can be viewed in full on the CMS website (www.CMS.gov). This year’s proposal includes reimbursement changes, modifications to value-based payments, potential relative value unit (RVU) changes, under attack codes, and a change in global periods for future years, among others.

Affected entities had until September 2 to submit comments on the proposed rule. The AUA and other groups continue to prepare comments. For now, these are just proposals; the final rule will be published in late October or early November.

TARGETED MISVALUED CODES:

For 2015, Medicare has identified a few codes that are “misvalued,” meaning that Medicare feels the codes are valued too high. Here is a list of included CPTs significant to urology:

Cystourethroscopy as a separate procedure (52000)
Abdominal ultrasounds (76700, 76705)
One urodynamics code (51728)
Post-void residual (51798)
Bladder instillation (51700)
Prostate needle biopsy (55700)

Pathology-related prostate biopsy codes are also under review with the intention of deleting all three of the high-volume prostate G codes and keeping only the 10-20 G code at its current value.

Keep an eye on our monthly newsletter and we will continue to inform you as soon as changes are finalized.

Source: Urology Times.