Be ready to implement these key 2010 changes right away in January

Why This Topic Matters

These changes affect how practices bill, report, and receive payment at the beginning of 2010. Staying current helps reduce claim problems, align documentation and reporting processes, and prepare staff for Medicare policy shifts.

Article Sections

1. Consults and inpatient E/M changes

   Discusses changes affecting Medicare consult billing and the shift to other E/M service categories for certain encounters. Also covers related inpatient admitting-physician reporting topics.

2. Key billing and payment changes effective in January

   Introduces several Medicare updates scheduled to take effect in January, including coverage, modifier review, hospice reporting, therapy, enrollment, deductible, premium, mental health, and payment adjustments.

3. PET coverage change

   Summarizes an update to coverage for a specific imaging service related to cervical cancer and the timing of the policy change.

4. Modifier reviews

   Addresses claim review changes for certain surgery-related modifiers and the carrier review process.

5. Hospice billing changes

   Covers updated hospice reporting requirements involving physician identification on election and claim forms.

6. Therapy cap exceptions

   Explains the status of the therapy cap exceptions process and the annual cap amounts for therapy services.

7. Enrollment appeals

   Describes expanded appeal rights for additional types of enrollment denials and changes to denial notice delivery.

8. Deductible and premium changes

   Lists updated beneficiary cost-sharing amounts and income-related premium levels for the year.

9. Mental health limitation

   Summarizes the phased adjustment to Medicare’s share of mental health service payments.

10. Welcome to Medicare boost

    Notes a payment update for the Welcome to Medicare service and the related billing code referenced in the article.

11. Blood flow measurement coverage

    Discusses coverage policy changes for MRI-based blood flow measurement and the transition to a CPT add-on code in 2010.

12. Blood clotting factor fee boost

    Highlights an additional payment associated with furnishing blood clotting factors and the code referenced in connection with that payment.

13. Radiology interpretation place of service

    Reviews guidance on reporting place of service for radiology interpretations performed in nontraditional locations and carrier education on that topic.