January 2014
The essential resource for your practice
Volume XXI, Number 1

AUA Attends State Legislative Strategy Conference

The AUA recently attended the annual State Legislative Strategy Conference, hosted by the American Medical Association (AMA). The meeting was attended by professional staff members from national physician specialty organizations and state medical societies; and  allowed the AUA to form and enhance valuable partnerships with organizations active throughout the nation.

Table of Contents

  

Coding Corner:

2014 CPT Code Changes Affecting Urology

MedPAC Makes Recommendations for March Report to Congress

On January 16-17, 2014, the Medicare Payment Advisory Commission (MedPAC) held its first meeting of the year to vote on issues discussed at the December meeting and to make recommendations for the annual March report to Congress. Last month, the Commission discussed site-neutral payments for facility and non-facility services, policy options for accountable care organizations (ACOs) and payment adequacy for services provided in ambulatory surgical centers (ASCs) and long-term care hospitals (LTCH). By law, each year the Commission is required to review payment policies under the Medicare program and make recommendations to Congress.

Assessing Payment Adequacy and Payment Updates for Inpatient, Outpatient and Long-Term Care

To align hospital outpatient department (OPD) payment rates with physician payment rates when the same service is provided in the office, the Commission voted to reduce or remove payment distortions for 66 selected ambulatory payment classifications (APCs).  The recommendation is based on several criteria that would eliminate payment inconsistencies between OPDs and freestanding physician offices, which include services performed 50 percent or more of the time in the office, do not have a 90-day global period, are infrequently provided with an emergency department visit, the patient severity is no greater than in the OPD, and packaging differences across settings are minimal. According to MedPAC’s analysis, this would reduce hospital program spending and cost sharing by $1.1 billion per year, and lower hospitals’ Medicare revenue by 0.6 percent.

For The Record

Making the Most of the AUA Coding Hotline

Welcome to a new year with the American Urological Association! For those Coding Hotline subscribers who have renewed with us or have recently joined us in 2014, please take a moment to learn about the process for using this service. Our team of certified coders is here to assist you with your most difficult and challenging operative reports.

Electronic Prescribing Incentive Program Discontinued

Effective January 1, 2014, the electronic prescribing (E-Rx) incentive initiated in 2011 by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) has expired. Therefore, adding G8553 to the claims of patients who have received an E-Rx is unnecessary. The Medicare Electronic Health Record (EHR) Incentive program (also known as Meaningful Use, or MU) contains a core measure for electronic prescribing of drugs ordered through the EHR. The E-Rx requirement in the MU program is expected to serve as an ongoing stimulus for physicians to continue to e-prescribe.