Find-A-Code Blog: March 2010

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Happy Coding!

"On March 2, 2010, President Obama signed into law the "Temporary Extension Act of 2010." Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010. Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment. Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

"In addition, the new law extends through March 31, 2010, the exception process for therapy claims reaching the annual cap, retroactive to January 1, 2010. Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions."

Claims are being processed, but the war isn't over. The battle will continue for at least another month.

A temporary measure to extend the January 1-February 28 freeze for another month passed the house, but was killed in a Senate filibuster. The Senate had issues with the bill that passed the House of Representatives late last week. The House bill included an extension of unemployment benefits among other things. Beginning Monday March 1, this issue is again on the table (official Congressional docket). However, with a Circuit Court Judge nomination pending, it is unlikely that much will happen until later in the week.

On Friday, February 26, 2010, the Centers for Medicare and Medicaid Services issued the following statement:

"The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule (MPFS). The Department of Defense Appropriations Act of 2010 provided a zero percent (0%) update to the 2010 MPFS effective for dates of service January 1, 2010, through February 28, 2010.

"We believe Congress is working to avoid the negative update that will take effect March 1, 2010. Consequently, CMS has instructed its contractors to hold claims containing services paid under the MPFS for the first 10 business days of March. The holding of MPFS claims will only affect claims with dates of service March 1, 2010, and forward. This hold should have a minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt."

As of today, let's hope for a happy resolution and plan for a fee freeze. In the meantime, you may wish to NOT submit claims to Medicare for a few days. If you do submit a claim, it will not be processed until the fee problem has been resolved.

If any changes are made to the payment system, Find-A-Code will update our site with these changes as they become available.