Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods. Maxine
Can you please send me a link to the list? I haven't been able to find it. Thanks
-----Original Message----- From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com] Sent: Monday, December 19, 2016 10:59 AM To: Multiple recipients of list PARTB-L Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods. Maxine
Physicians, Hospitals and Payers working together for the Patient 751 E. Daily Dr. Suite 120, Camarillo, CA 93010 Office: 805.256.7810 Direct: 805.256.7821 Fax: 805.256.7842 keri.yarbrough@identityMSO.com
This is my understanding of the 99024 thing. Please correct me if I'm wrong.
As to a "list", then I think you would need to see the entire MPFS showing the number of global fee period days and if a service is within a global fee period of a previous surgery, then I would guess you need to use the 99024.
In 2015, CMS proposed a change that would eliminate the “global fee period” concept from the 90 and 10 day period they have on many codes so that all codes would have a 0 day global (meaning that services performed on the same day as the procedure would be bundled into the payment for the procedure, but zero additional days). MACRA had a provision in it that was enacted April 16, 2015 that prohibited the Secretary of the HHS from unilaterally deciding to make that change, but it did have a provision for the CMS to collect data to value surgical services.
That collection of data will begin January 1st at CMS and HHS, which means you may get requests for information from CMS on what you are including in the surgery, what typical followup times you see as routine, etc. Keep in mind, folks, that this is not only for the general surgeons or cardiovascular surgeons, etc. This will be for all specialties because Medicare considers many non invasive procedures under the global fee concept. My advice is to answer them when they ask for it because they do have the permission granted by MACRA of holding back 5% of the physician fee schedule from physicians not providing the data when requested.
In addition to answering requests from CMS and MACs when sent to you, Medicare is requesting providers to voluntarily report code 99024 when they perform routine followup visits that are included in the surgery or global period.
Those visits will not be paid separately, but they will be used to help CMS determine future changes in the Medicare allowed amounts for surgeries based on routine global fee periods.
July 1st of 2017, CMS will require practitioners who practice in groups with 10 or more practitioners in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon and Rhode Island to report followup visits with non payable code 99024. They are requesting providers in all states voluntarily do so effective January 1st. They are trying to figure out what you’ve been doing and what is routine and what is not routine, so they’re requesting your help.
I do understand the rule, that’s not what I’m asking. I want to know which codes will require the mandatory reporting of 99024.
“Reporting will be required only for services related to codes reported annually by more than 100 practitioners and that are reported more than 10,000 times or have allowed charges in excess of $10 million annually. (List to be published by CMS)”
A recent webinar I did said there are 270 codes for which this applies, yet I cannot find a list anywhere that tells which codes are included.
Physicians, Hospitals and Payers working together for the Patient 751 E. Daily Dr. Suite 120, Camarillo, CA 93010 Office: 805.256.7810 Direct: 805.256.7821 Fax: 805.256.7842 keri.yarbrough@identityMSO.com
-----Original Message----- From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com] Sent: Monday, December 19, 2016 8:01 AM To: Multiple recipients of list PARTB-L Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com] Sent: Monday, December 19, 2016 10:59 AM To: Multiple recipients of list PARTB-L Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods. Maxine
-----Original Message----- From: Keri Yarbrough [mailto:Keri.Yarbrough@identitymso.com] Sent: Monday, December 19, 2016 11:19 AM To: Multiple recipients of list PARTB-L Subject: RE: RE:[partb-l] Reporting post-op visits
Physicians, Hospitals and Payers working together for the Patient 751 E. Daily Dr. Suite 120, Camarillo, CA 93010 Office: 805.256.7810 Direct: 805.256.7821 Fax: 805.256.7842 keri.yarbrough@identityMSO.com
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the addressee indicated in this message (or responsible for delivery of the message to such person), please contact the sender by reply e-mail and destroy all copies of the communication and any attachments.
-----Original Message----- From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com] Sent: Monday, December 19, 2016 8:01 AM To: Multiple recipients of list PARTB-L Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
-----Original Message----- From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com] Sent: Monday, December 19, 2016 10:59 AM To: Multiple recipients of list PARTB-L Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods. Maxine
This electronic message transmission contains information from ScrogginsGrear, Inc. which may be confidential or privileged. The information is intended for the use of the individual or entity named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please notify us by telephone (800-359-3970) or by electronic mail (consultants@scrogginsgrear.com) immediately. If any tax advice is contained in this communication, it is not intended or written to be used for the purpose of avoiding any penalties that may be imposed under federal law and cannot be used for that purpose.
-----Original Message----- From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com] Sent: Monday, December 19, 2016 10:25 AM To: Multiple recipients of list PARTB-L Subject: [partb-l] Reporting post-op visits
Has anyone seen the list yet for which codes CMS will be requiring the reporting of 99024???
I don't have the exact reference but here is additional info: In the 2017 PFS final rule, CMS is making the following changes to the global period reporting provision: Only providers in 9 states will be affected. In the single biggest change to the provision, CMS is exempting all practices from reporting except those in the following nine states. If you are not in one of these states, your providers are exempt. If your practice has fewer than 10 providers total, and you are in one of the nine states, you are also exempt from data reporting: Florida North Dakota Louisiana Kentucky Ohio Oregon Nevada Rhode Island New Jersey
-----Original Message----- From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com] Sent: Monday, December 19, 2016 11:22 AM To: Multiple recipients of list PARTB-L Subject: re:[partb-l] Reporting post-op visits
That's prior to the final rule.
-----Original Message----- From: Keri Yarbrough [mailto:Keri.Yarbrough@identitymso.com] Sent: Monday, December 19, 2016 11:19 AM To: Multiple recipients of list PARTB-L Subject: RE: RE:[partb-l] Reporting post-op visits
Physicians, Hospitals and Payers working together for the Patient 751 E. Daily Dr. Suite 120, Camarillo, CA 93010 Office: 805.256.7810 Direct: 805.256.7821 Fax: 805.256.7842 keri.yarbrough@identityMSO.com
-----Original Message----- From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com] Sent: Monday, December 19, 2016 8:01 AM To: Multiple recipients of list PARTB-L Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
-----Original Message----- From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com] Sent: Monday, December 19, 2016 10:59 AM To: Multiple recipients of list PARTB-L Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods. Maxine
Erica, At the AMA CPT symposium in November in Chicago they simply stated the affected codes will be on the CMS "soon"...no date was given and as far as I can tell they are still not on there. sr
So - the mandatory reporting will only be on specific codes. I missed that and glad you pointed it out. I wonder if that list of codes is also what they are requesting on the voluntary reporting or if we have to wait until before July 1st before we get a list of what codes are required to have the 99024 on. Alot of questions - but I guess we have about 6 more months to get the answers before the docs in those select states will be required to report.
On Dec 19, 2016, at 10:18 AM, Erica Schwalm wrote:
I do understand the rule, that’s not what I’m asking. I want to know which codes will require the mandatory reporting of 99024.
“Reporting will be required only for services related to codes reported annually by more than 100 practitioners and that are reported more than 10,000 times or have allowed charges in excess of $10 million annually. (List to be published by CMS)”
A recent webinar I did said there are 270 codes for which this applies, yet I cannot find a list anywhere that tells which codes are included.
Ah! Okay great thanks... as long as I'm not crazy. Haha I'll keep checking back and if I find it, I will share.
Thanks!
Erica, At the AMA CPT symposium in November in Chicago they simply stated the affected codes will be on the CMS "soon"...no date was given and as far as I can tell they are still not on there. sr
Comments
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
-----Original Message-----
From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com]
Sent: Monday, December 19, 2016 10:59 AM
To: Multiple recipients of list PARTB-L
Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods.
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
Has anyone seen the list yet for which codes CMS will be requiring the reporting of 99024???
Keri Yarbrough, Billing and Collections
Physicians, Hospitals and Payers working together for the Patient
751 E. Daily Dr. Suite 120, Camarillo, CA 93010
Office: 805.256.7810
Direct: 805.256.7821
Fax: 805.256.7842
keri.yarbrough@identityMSO.com
As to a "list", then I think you would need to see the entire MPFS showing the number of global fee period days and if a service is within a global fee period of a previous surgery, then I would guess you need to use the 99024.
In 2015, CMS proposed a change that would eliminate the “global fee period” concept
from the 90 and 10 day period they have on many codes so that all codes would have a
0 day global (meaning that services performed on the same day as the procedure
would be bundled into the payment for the procedure, but zero additional days).
MACRA had a provision in it that was enacted April 16, 2015 that prohibited the
Secretary of the HHS from unilaterally deciding to make that change, but it did have a
provision for the CMS to collect data to value surgical services.
That collection of data will begin January 1st at CMS and HHS, which means you may
get requests for information from CMS on what you are including in the surgery, what
typical followup times you see as routine, etc. Keep in mind, folks, that this is not only
for the general surgeons or cardiovascular surgeons, etc. This will be for all
specialties because Medicare considers many non invasive procedures under the
global fee concept. My advice is to answer them when they ask for it because they do
have the permission granted by MACRA of holding back 5% of the physician fee
schedule from physicians not providing the data when requested.
In addition to answering requests from CMS and MACs when sent to you, Medicare is
requesting providers to voluntarily report code 99024 when they perform routine
followup visits that are included in the surgery or global period.
Those visits will not be paid separately, but they will be used to help CMS determine future changes in the
Medicare allowed amounts for surgeries based on routine global fee periods.
July 1st of 2017, CMS will require practitioners who practice in groups with 10 or more
practitioners in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio,
Oregon and Rhode Island to report followup visits with non payable code 99024. They
are requesting providers in all states voluntarily do so effective January 1st. They
are trying to figure out what you’ve been doing and what is routine and what is not
routine, so they’re requesting your help.
Don
Don Self & Associates, Inc
305 Senter Ave, Whitehouse, TX 75791
903 871-1172 fax 480-247-5650
donself@donself.com web: www.donself.com
books & webinars at https://shop.donself.com
“Reporting will be required only for services related to codes reported annually by more than 100 practitioners and that are reported more than 10,000 times or have allowed charges in excess of $10 million annually. (List to be published by CMS)”
A recent webinar I did said there are 270 codes for which this applies, yet I cannot find a list anywhere that tells which codes are included.
Thanks
This is what I found.
Keri Yarbrough, Billing and Collections
Physicians, Hospitals and Payers working together for the Patient
751 E. Daily Dr. Suite 120, Camarillo, CA 93010
Office: 805.256.7810
Direct: 805.256.7821
Fax: 805.256.7842
keri.yarbrough@identityMSO.com
-----Original Message-----
From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com]
Sent: Monday, December 19, 2016 8:01 AM
To: Multiple recipients of list PARTB-L
Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com]
Sent: Monday, December 19, 2016 10:59 AM
To: Multiple recipients of list PARTB-L
Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods.
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
-----Original Message-----
From: Keri Yarbrough [mailto:Keri.Yarbrough@identitymso.com]
Sent: Monday, December 19, 2016 11:19 AM
To: Multiple recipients of list PARTB-L
Subject: RE: RE:[partb-l] Reporting post-op visits
https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2016-08-11-MACRA-Presentation.pdf
This is what I found.
Keri Yarbrough, Billing and Collections
Physicians, Hospitals and Payers working together for the Patient
751 E. Daily Dr. Suite 120, Camarillo, CA 93010
Office: 805.256.7810
Direct: 805.256.7821
Fax: 805.256.7842
keri.yarbrough@identityMSO.com
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the addressee indicated in this message (or responsible for delivery of the message to such person), please contact the sender by reply e-mail and destroy all copies of the communication and any attachments.
-----Original Message-----
From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com]
Sent: Monday, December 19, 2016 8:01 AM
To: Multiple recipients of list PARTB-L
Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
-----Original Message-----
From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com]
Sent: Monday, December 19, 2016 10:59 AM
To: Multiple recipients of list PARTB-L
Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods.
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
This electronic message transmission contains information from ScrogginsGrear, Inc. which may be confidential or privileged. The information is intended for the use of the individual or entity named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please notify us by telephone (800-359-3970) or by electronic mail (consultants@scrogginsgrear.com) immediately. If any tax advice is contained in this communication, it is not intended or written to be used for the purpose of avoiding any penalties that may be imposed under federal law and cannot be used for that purpose.
-----Original Message-----
From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com]
Sent: Monday, December 19, 2016 10:25 AM
To: Multiple recipients of list PARTB-L
Subject: [partb-l] Reporting post-op visits
Has anyone seen the list yet for which codes CMS will be requiring the reporting of 99024???
In the 2017 PFS final rule, CMS is making the following changes to the global period reporting provision:
Only providers in 9 states will be affected. In the single biggest change to the provision, CMS is exempting all practices from reporting except those in the following nine states. If you are not in one of these states, your providers are exempt. If your practice has fewer than 10 providers total, and you are in one of the nine states, you are also exempt from data reporting:
Florida
North Dakota
Louisiana
Kentucky
Ohio
Oregon
Nevada
Rhode Island
New Jersey
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
-----Original Message-----
From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com]
Sent: Monday, December 19, 2016 11:22 AM
To: Multiple recipients of list PARTB-L
Subject: re:[partb-l] Reporting post-op visits
That's prior to the final rule.
-----Original Message-----
From: Keri Yarbrough [mailto:Keri.Yarbrough@identitymso.com]
Sent: Monday, December 19, 2016 11:19 AM
To: Multiple recipients of list PARTB-L
Subject: RE: RE:[partb-l] Reporting post-op visits
https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2016-08-11-MACRA-Presentation.pdf
This is what I found.
Keri Yarbrough, Billing and Collections
Physicians, Hospitals and Payers working together for the Patient
751 E. Daily Dr. Suite 120, Camarillo, CA 93010
Office: 805.256.7810
Direct: 805.256.7821
Fax: 805.256.7842
keri.yarbrough@identityMSO.com
-----Original Message-----
From: Erica Schwalm [mailto:Erica.Schwalm@convergentsolutions.com]
Sent: Monday, December 19, 2016 8:01 AM
To: Multiple recipients of list PARTB-L
Subject: RE:[partb-l] Reporting post-op visits
Can you please send me a link to the list? I haven't been able to find it. Thanks
-----Original Message-----
From: Maxine Lewis [mailto:MLewis@scrogginsgrear.com]
Sent: Monday, December 19, 2016 10:59 AM
To: Multiple recipients of list PARTB-L
Subject: RE: [partb-l] Reporting post-op visits
Yes, this is part of deleting global periods. CMS needs the data to probably reduce the RVUs for surgery and allow a payment for the post-op periods.
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
Has anyone seen the list yet for which codes CMS will be requiring the reporting of 99024???
At the AMA CPT symposium in November in Chicago they simply stated the affected codes will be on the CMS "soon"...no date was given and as far as I can tell they are still not on there.
sr
Susan Rohde, RHIT, CCS-P, CPC
Physician Coding Manager
Eide Bailly LLP
4310 17th Ave. S.
P.O. Box 2545
Fargo, ND 58108-2545
T 701.239.8540
M 218.205.6429
WAN 722.0000
www.eidebailly.com
Experience the Eide Bailly Difference
Don
Don Self & Associates, Inc
305 Senter Ave, Whitehouse, TX 75791
903 871-1172 fax 480-247-5650
donself@donself.com web: www.donself.com
books & webinars at https://shop.donself.com
On Dec 19, 2016, at 10:18 AM, Erica Schwalm wrote:
I do understand the rule, that’s not what I’m asking. I want to know which codes will require the mandatory reporting of 99024.
“Reporting will be required only for services related to codes reported annually by more than 100 practitioners and that are reported more than 10,000 times or have allowed charges in excess of $10 million annually. (List to be published by CMS)”
A recent webinar I did said there are 270 codes for which this applies, yet I cannot find a list anywhere that tells which codes are included.
Thanks
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-11-02.html
[Description: Description: R:\General\Graphics\ScrogginsGrear\Correct Colors\ScrogginsGrear One Line Signature.png]
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
Thanks!
Erica,
At the AMA CPT symposium in November in Chicago they simply stated the affected codes will be on the CMS "soon"...no date was given and as far as I can tell they are still not on there.
sr
Susan Rohde, RHIT, CCS-P, CPC
Physician Coding Manager
Eide Bailly LLP
4310 17th Ave. S.
P.O. Box 2545
Fargo, ND 58108-2545
T 701.239.8540
M 218.205.6429
WAN 722.0000
www.eidebailly.com
Experience the Eide Bailly Difference