Medicare Changes
Effective October 1, 2001, code 76977 for ultrasound bone density measurement will see about a 40% decrease in reimbursement for both the global and technical component when done in a physician’s office. This is due to a reduction in the Non-Facility Practice Expense RVU.
The globals for codes 11976, 15824, 15825, 15826, 15828, 15829, 15876, 15877, 15879, 17380, 33960, 36468, 36469, 41820, 41821, 41850, and 41870 have been set to 000 days. This means that an Evaluation and Management service provided on the same day usually isn’t payable.
Surgical codes 34800, 34802, 34804, 34808, 34812, 34813, 34820, 34825, 34826, 34830, 34831, 34832, 36870, 43231, 43232, 48554, and 48556 will be allowed co-surgeons of different specialties.
The bilateral payment of adjustment of 150% will not apply for bilateral surgery codes 73718 and 73719. Modifier –50 or listing the codes twice will not increase the reimbursement. Your reimbursement will be based on the fee for a single code.
Team surgeons will now be allowed for codes 48554 and 48556. Carriers will pay by report.
The standard multiple procedure adjustment (100% for the 1st procedure, 50% for the 2nd, 3rd, etc.) will now apply to code 17004 but not to 34826.
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