tci Medicare Compliance & Reimbursement - 2013 Issue 7
Reimbursement: Good News: Expect More Pay for These 10 Procedures
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Article Overview
This article reviews selected CMS updates to the Medicare Physician Fee Schedule, with emphasis on bilateral procedure indicator changes, retroactive effective dates, and payment status revisions for a G code. It is aimed at coding and reimbursement professionals who need to understand which service categories were affected and how the quarterly update may influence claim payment behavior.
Why This Topic Matters
The update can affect how certain procedures are reported and reimbursed under Medicare, including whether claims may qualify for additional payment and whether some services are now payable under revised status indicators. Readers who bill these services need to know which code families were changed and the effective dates involved.
What You Will Learn
- How CMS quarterly fee schedule updates can affect reimbursement for bilateral procedures
- Which broad procedure categories were affected by bilateral indicator changes
- How a payment status revision for a G code can change claim payment eligibility
- That some changes were applied retroactively to an earlier effective date
- Where to find the full CMS update document referenced by the article
Who Should Read This
- Medical coders
- Coding auditors
- Billing specialists
- Reimbursement staff
- Practice managers
- Physician office staff
- Hospital coding professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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