decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 9 (September)
Proposed fee schedule: Remember to comment - CMS to reconsider cataract surgery, drug screen codes
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Article Overview
This article previews selected items in CMS’s proposed 2016 physician fee schedule and notes related clinical laboratory fee schedule activity. It is relevant to anesthesia providers, practices that perform drug testing, and coders following CMS payment policy updates and public comment opportunities. The discussion focuses on broad areas under review, including cataract-related anesthesia, gastrointestinal endoscopy, neurostimulator evaluation services, and major changes proposed for drug screen reporting.
Why This Topic Matters
The article highlights CMS proposals that could affect payment, reporting volume, and comment strategy for multiple service lines. It helps readers track which parts of the fee schedule and laboratory policy process are under review and where further CMS updates are expected.
Article Sections
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Comment period and fee schedule update timeline
Introduces the 2016 physician fee schedule comment window and notes related CMS laboratory fee schedule timing. It also points readers to where additional public information is expected.
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Anesthesia for cataract services
Summarizes CMS interest in cataract surgery settings and the potential impact on anesthesia billing. The section discusses why this area is being reviewed and who may be affected.
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Upper and lower gastrointestinal endoscopy
Covers CMS’s review of payment policy for anesthesia services tied to gastrointestinal endoscopy. It explains that the agency is reconsidering certain procedure categories in light of utilization patterns.
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Neurostimulator evaluation payments
Describes CMS scrutiny of evaluation services associated with neurostimulator-related care. It notes that these services are being considered for payment review.
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Drug screen code overhaul
Discusses CMS’s proposal to replace the current drug screen coding structure with a simplified approach. The section focuses on the scope of the proposed change and its implications for Medicare and potentially other payers.
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Submitting comments and monitoring CMS resources
Provides general guidance on where comments may be submitted and where to watch for additional CMS updates. It also mentions related resource links referenced by the article.
What You Will Learn
- Which CMS fee schedule areas are being reviewed in this update
- What types of anesthesia-related services are under consideration
- How CMS is approaching endoscopy and neurostimulator payment review
- What broad changes are proposed for drug testing code reporting
- Where to watch for public comment and follow-up CMS postings
Who Should Read This
- Medical coders
- Anesthesia providers
- Practice managers
- Compliance staff
- Billing departments
Codes Discussed
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