AMA Bookstore News, Jan. 17, 2012
Coding with Modifiers, Fourth edition
The ultimate modifiers resource—revised! Coding with Modifiers provides guidance on how and when to use modifiers with the 2012 code set. The fourth edition contains new, deleted and revised modifiers, along with updates to Centers for Medicare & Medicaid Services, third-party payer and AMA-modifier guidelines.
- Coding tips— explain how to use specific modifiers to help clear up confusion
surrounding modifier usage
- Modifiers approved for hospitals and ASCs— provide information for
professional service and hospital reporting requirements
- Teaching tools— allow you to create and administer tests using questions and
answers developed by the AMA
- Clinical examples— guide readers in determining the correct modifier to use with
- Test-Your-Knowledge questions— test your comprehension of the material with
more than 190 questions
CPT® 2012 Professional Edition
Covering hundreds of code, guideline and text changes, CPT® 2012 Professional Edition helps users correctly interpret and report medical procedures and services. Straight from the American Medical Association (AMA), this is the only CPT® codebook with the official CPT coding rules and guidelines developed by the CPT Editorial Panel.
- Section-specific table of contents—provide users with an efficient tool to navigate information relevant to the codes listed in each section
- Coding tips added throughout—a select group of helpful tips added throughout each section to aid in better understanding
- E/M reference tables—summarize the requirements for reporting E/M services and help to select and validate proper E/M coding
- Anatomical and procedural illustrations incorporated within the code sections—help users accurately code procedures
- Reference tables for quick identification of the codes—assist in understanding the definition and differentiation of key parameters in large families of codes
The product showcase featured in AMA Bookstore News changes with each edition. This offer is only valid until Feb. 13, 2012.
When you purchase the CPT 2012 Modifiers AMA Express Reference Card, you may notice the significant addition of new HCPCS modifier PD. The long descriptor for PD reads as such: Diagnostic or related nondiagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days. The Express Reference Card displays the shorter descriptor Inp admit w/in 3 days. The modifier will aid hospitals in indentifying services that fall within the Medicare three-day payment window.
As of January 1, 2012, modifier PD is available for use by wholly owned or wholly operated entities and should be appended to claims subject to the three-day payment window. Implementation of the modifier, however, has been delayed until July 1, 2012 in an effort to allow hospitals and their wholly owned or wholly operated entities to sync up their billing and accounting systems.
See pages 73282–73286 of the November 28, 2011, issue of the Federal Register (vol. 76, no. 228) for more information about the new Level II modifier.
Whether you are starting a new practice, buying an existing practice or simply wanting to build your current patient base, here are a some helpful marketing techniques.
Create a marketing plan and share it with your staff, who will be an integral part of your marketing efforts. This plan needn’t be complicated, but should be thorough and easy to follow.
Develop a website. Today’s patients expect to have information at their fingertips. This website will provide quick and easy access to information about your practice, and provide increased visibility to prospective patients.
Produce a brochure. Brochures serve as a compact reference about your practice and can be mailed or distributed for potential patients to receive or pick up. This brochure should provide a quick overview of your practice including: What services are available, your office’s policies, contact information and other information pertinent to potential patients.
More detailed information on how to market your practice can be found in Starting, Buying, and Owning the Medical Practice.
The AMA is in the process of finalizing Medicare RBRVS-related products after passage of legislation that delayed, until March 1, the 27.4% Medicare pay cut due to the Sustainable Growth Rate formula. These reimbursement products, including Medicare RBRVS 2012: The Physicians’ Guide, RBRVS Data Manager 2012, CPT/RVU 2012 ASCII Data File, and CodeManager® Online will incorporate the latest data and Medicare payment schedule information as relapsed by the Centers for Medicare and Medicaid Services (CMS) on January 4.
On December 23, President Obama signed into law the Temporary Payroll Tax Cut Continuation Act of 2011 (H.R. 3765). This legislation averts the anticipated 27.4% cut to Medicare payments and implements a two-month freeze on the conversion factor from January 1 through February 29, 2012. It also extends the floor on the work geographic practice cost index (GPCI) and certain other policies.
CMS has confirmed to the AMA, however, that all of the other changes that were included in the Medicare physician payment final rule for 2012 will still take effect. Physicians should not expect that payment rates will remain unchanged. Numerous changes are being made in the relative value units, GPCIs, electronic prescribing and quality reporting programs, and multiple procedure payment rules for 2012. All of these changes will take effect as scheduled for dates of service beginning Jan. 1, 2012.
Modifier 78 is used when a related procedure is performed during the postoperative period which is unplanned. Learn about this, and other modifier changes, with the fourth and latest edition of Coding with Modifiers.
Question: During a 72-hour portable recording of EEG, a single-lead cardiac rhythm is also obtained and is inherent in the EEG device capability. Is it appropriate to additionally report the ECG monitoring?
Answer: ECG recording is not a standard component of a computer-assisted ambulatory 24-hour EEG service. The medical goal in this testing is to capture the EEG and ECG during the patients usual symptoms or during subclinical episodes of the same event (eg, when the patient presents with lapses of consciousness of unknown cause and for which both epileptic and cardiac causes are being considered).
Code 93799, Unlisted cardiovascular service or procedure, should be reported if the combined 72-hour EEG plus ECG recording does not continuously store the tracings.
If the type of ECG monitoring system meets the criteria for reporting code 93224, External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, physician review and interpretation, then the 72-hour duration may be delineated by appending the modifier 22, Increased Procedural Services.
Get CPT® Assistant Newsletter for more coding Q&A, tips and interpretations!
A highlight of the AMA Bookstore portfolio, CodeManager® Online: Elite combines the most essential medical references in an easy-to-use, web-based coding and payment reference tool.
The latest CPT®, ICD-9-CM and HCPCS codes provide the foundation for CodeManager Online. The enhanced Elite level maximizes practice efficiency and accuracy by also providing the latest Medicare data, Dorland's Illustrated Medical Dictionary, the top-five related ICD-9-CM to CPT codes, more than 3,200 AMA exclusive CPT® vignettes and much more! View a comparison chart of the three levels to determine which level meets the needs of your practice.
Try before you buy! Sign up for a 14-day free trial of the Elite level today or register yourself—or your entire office—for the February 14th CodeManager Online: Elite webinar that is hosted by a coding information specialists.
What others are saying:
- “I appreciate the fact that the associated CPT® Assistant articles are listed under the codes.”
- “The feature to change the date of service in CodeManager Online: Elite is very helpful to review historical data.”
- “I love the addition of the LCDs.”
Meet renowned AMA author James B. Talmage, MD, FAADEP. When he’s not too busy treating patients, lecturing physicians or serving as president of the American Academy of Disability Evaluating Physicians, Dr. Talmage finds time to serve as an author, contributor and editor for the AMA’s line of impairment and disability-related publications.
In 2011, Dr. Talmage co-authored the second edition of AMA Guides™ to the Evaluation of Work Ability and Return to Work. This best-selling book emphasizes the positive impacts of working and provides guidance for physicians and health care professionals who handle complex work and ability-related issues.
Current scientific studies are clear that returning to work and staying at work is usually in the patient’s best interest. This publication presents the latest literature and science related to this subject and also details how to think through the concepts of “risk”, “capacity” and “tolerance” to get a patient back to work. Dr. Talmage became interested in this area of medicine when he realized that he, like other physicians, was expected to write work guidelines for patients even though he had never been formally trained in this area.
Dr. Talmage is board-certified in orthopedic surgery and emergency medicine. He has contributed to numerous medical publications, including Guides to the Evaluation of Permanent Impairment, sixth edition. He chaired the spine committee that wrote the 2007 update to the low-back chapter in the American College of Occupational and Environmental Medicine’s Occupational Medicine Practice Guidelines, second edition, and the 2010 update to the neck chapter. Dr. Talmage also teaches for numerous medical organizations and is an adjunct associate professor for Meharry Medical College in Nashville, Tenn.
Learn more about the AMA Guides to the Evaluation of Work Ability and Return to Work.
The DISASTER Paradigm™ is an all-hazards approach to disaster planning, training and response. Regardless of the cause of the disaster, the basic tenets of disaster management are the same. Each letter in this paradigm applies to a key element in the health response to any mass casualty event.
These elements are:
D = Detection
I = Incident management
S = Safety and security
A = Assess hazards
S = Support
T = Triage and treatment
E = Evacuation
R = Recovery
As a health care provider, it is imperative that you know what to do in a disaster or emergency, and know your legal and ethical obligations for treating casualties. The National Disaster Life Support Foundation™ provides DISASTER Paradigm™ training throughout the United States and internationally. Start with Core Disaster Life Support® as the foundation and move through the three levels of training to advance your knowledge.
AMA Category I CME is available for each course, and most nursing, EMS and related professional organizations will offer 1 for 1 credit.
Stop by Booth 4260 at this year’s American Academy of Orthopaedic Surgeons (AAOS) annual meeting and take advantage of special offers, including: free shipping and discounted pricing on all AMA products! Featured publications include the AMA Guides™ impairment evaluation line; a 2011 update to the best-selling Return to Work publication; HIPAA Plain & Simple; and the 2012 CPT® core coding line. We also have complimentary issues of the AMA Guides™ Newsletter—your source for expert advice, practical information and current trends on impairment evaluation. Can’t stop by the booth? Visit amabookstore.com or call (800) 621-8335 to learn more.