decisionhealth Newsletters, Coder Pink Sheets - 2005 Issue 12 (December)
Pay for domiciliary and rest home visits rises in 2006, time now considered
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Article Overview
This article is aimed at coding and reimbursement professionals who need to understand 2006 changes in CPT-based visit and procedure coding, along with CMS valuation decisions in the Medicare Physician Fee Schedule. It covers expanded visit code families, deleted and replacement codes, and selected orthopedic and pain-management procedure codes discussed in the context of RVUs, facility status, and emerging time-related wording.
Why This Topic Matters
The changes described affect code selection, fee schedule payment, and documentation expectations for common evaluation and procedure services. Readers working in physician billing, orthopedic coding, podiatry, pain management, or Medicare reimbursement will want to know which code families changed and how CMS approached valuation.
Article Sections
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Overview of 2006 visit code changes
Introduces the broad update to domiciliary, rest home, and related visit coding for 2006. Summarizes the shift to expanded code families and revised valuation.
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Time in the new visit descriptors
Discusses the role of typical time in the revised visit code language. Notes the broader issue of how time references are being handled across code families.
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Other payment decisions of interest to orthopedic practices
Reviews additional Medicare valuation updates affecting selected procedure services. Includes brief discussion of concerns raised by practitioners and the use of RVUs in the fee schedule.
What You Will Learn
- How the 2006 revisions changed certain visit code families
- Why time language became part of some revised descriptors
- How CMS and CPT approached valuation updates for selected procedures
- Which specialties and practice settings are most likely to be affected by these changes
Who Should Read This
- Physician coders
- Medical billers
- Compliance staff
- Practice managers
- Orthopedic coding specialists
- Podiatry billing professionals
- Pain management coders
Codes Discussed
Code Ranges Discussed
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