tci Medicare Compliance & Reimbursement - 2012 Issue 5
Part B Update: Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
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Article Overview
This premium update reviews Medicare Part B coding and billing policy changes discussed by CMS, with emphasis on how a CPT revision affects or does not affect Medicare processing. It also covers operational topics that matter to billing staff and compliance teams, including claims reprocessing related to the Affordable Care Act and the start of e-prescribing payment adjustments. The article is relevant for physicians, non-physician practitioners, coders, and revenue cycle staff who need to track Medicare guidance and claims administration updates.
Why This Topic Matters
The article helps readers understand when a national coding reference changes but Medicare systems do not follow in the same way, which can affect claim submission and patient status classification. It also flags administrative deadlines and payment adjustment issues that may influence reimbursement and follow-up work.
Article Sections
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Background
Introduces the Medicare Part B context for a CPT update and explains why the topic matters to billing and claims processing. It outlines the general policy area without delving into code-specific guidance.
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Claims Reprocessing Finally Completed
Summarizes CMS updates on claims reprocessing tied to prior Medicare payment changes and the completion of that initiative. It also notes the follow-up relevance for accounts receivable review.
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E-Prescribing Penalties Kicked In
Covers CMS’s announcement that e-prescribing payment adjustments are now in effect and highlights the related reporting and timing considerations. The section is aimed at practices monitoring Medicare payment impacts.
What You Will Learn
- How Medicare Part B responded to a CPT update affecting patient status terminology
- What CMS said about claims reprocessing progress and completion
- How e-prescribing payment adjustments affect Medicare billing operations
- Which types of practice workflows may need review after CMS updates
Who Should Read This
- Physicians
- Non-physician practitioners
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance staff
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