Part B Payment: Watch for Coding Changes in 2015 Physician Fee Schedule

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews proposed changes in the 2015 Medicare Physician Fee Schedule and explains why they matter to physicians, coders, and billing staff following CMS payment policy updates. It highlights broad areas where coding and valuation proposals may affect reporting, payment, and comment opportunities, including imaging, obesity treatment services, biopsies, epidural services, colorectal screening-related anesthesia, and procedures involving moderate sedation. The article is relevant for professionals monitoring Medicare Part B policy, CPT and HCPCS code changes, and CMS valuation issues.

Why This Topic Matters

CMS payment proposals can affect how services are reported, valued, and billed under Medicare Part B. Understanding the scope of these proposed changes helps practices track policy updates and prepare for potential documentation and coding impacts.

Article Sections

  1. Mammography

    Discusses proposed Medicare payment and coding changes affecting mammography services and the related CMS valuation review process.

  2. Behavioral therapy

    Covers proposed additions related to intensive behavior therapy for obesity and the broader treatment category under review.

  3. Prostate biopsies

    Summarizes proposed simplification of coding for prostate biopsy services and related CMS valuation considerations.

  4. Epidurals

    Addresses proposed valuation changes for epidural services and CMS discussion of associated billing and guidance issues.

  5. Colonoscopies

    Describes proposed changes tied to colorectal cancer screening and separately provided anesthesia services in the screening setting.

  6. Moderate sedation

    Reviews CMS interest in reexamining valuation assumptions for services where moderate sedation may no longer be typical.

What You Will Learn

  • Which broad service categories are included in the proposed 2015 Medicare Physician Fee Schedule update.
  • How CMS is approaching valuation review for services under discussion.
  • What types of coding and billing topics may be affected by the proposed policy changes.
  • Why coders and billing staff may want to monitor CMS comment opportunities for these proposals.

Who Should Read This

  • Medical coders
  • Billing staff
  • Practice managers
  • Physician practices
  • Medicare compliance staff

Codes Discussed

  • HCPCS Level II: G0416

Code Ranges Discussed

  • HCPCS Level II: G codes

Modifiers Discussed

  • Unspecified: modifier

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