decisionhealth Newsletters, Part B News - 2003 Issue 12 (December)
You get 90-day grace period to use old codes
Subscribe or sign in to view the full article.
Article Overview
This article covers a Medicare coding transition tied to newly effective CPT code changes and the related grace period for claims processing. It is aimed at physicians, coders, billing staff, and reimbursement professionals who need to understand how the change may affect claim adjudication, payer behavior, and review of denied claims during the early months of the year. The discussion includes broad guidance on carrier payment systems, Correct Coding Initiative edits, and an example involving central venous catheter coding changes.
Why This Topic Matters
It helps readers recognize that a code transition period can affect payment outcomes and claim denials even when code sets are changing. The topic is especially relevant for practices reviewing claims submitted during the early effective period of new CPT updates.
Article Sections
-
Grace period for new CPT codes
Explains the general transition period for newly effective CPT codes and its possible effect on Medicare carrier payment systems and claim review. It also addresses how this period may relate to denials and payer processing.
-
Example of central venous catheter coding changes
Provides a practical example of how one area of CPT coding changed for the new year and how the transition period may apply. The section focuses on the broader coding change in central venous catheter services.
-
Payment expectations and payer review
Summarizes the general payment impact of the new codes and notes the need to review private payer claims. It also references distribution of a code-update spreadsheet to subscribers.
What You Will Learn
- How a Medicare grace period can affect claims during CPT code transitions
- Why new code sets may change payment processing
- What to watch for when reviewing denied claims during the early part of the year
- How carrier systems and payer edits may behave during the transition period
- How a central venous catheter coding update illustrates the broader changeover process
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Reimbursement specialists
- Practice managers
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com