Posts

Pediatric Utilization and RVU 2008

As promised – or threatened, I suppose – here is a breakdown of the expected impact of the 2008 coding changes based on pediatric utilization. I logged back in to add the punchline, which I forgot to add in my spreadsheet nerdiness: if it weren’t for the expected 10% Medicare cut, pediatricians would see an …

Bad News Update from Medicare (RVU 2008)

Received this from a chain of interested parties (AMA -> AAP -> little ol’ me) regarding the status of the 10% cut presently scheduled for Medicare: …attached for your information is a letter that HHS Secretary Leavitt sent to Chairman Baucus on Monday regarding the Senate Finance Medicare package. It states that any legislation to …

2008 RVU Analysis, Part I – GPCI!

Each year, when the new RVU values and rates are announced, a tremendous amount of attention is paid to the “Conversion Factor” – is it going down 10% this year, after all? Will the cut only be 5%? Could it go up by 5%? Most of the time, little attention is paid to the subtle …

Stop Making the Picket Signs . . . (UHC-25)

We have had confirmation that the recent bulletin from UHC interpreted to mean that they intended to delay -25 modifier payments indefinitely does not refer to the -25 modifiers!  They are still on track for a Dec 8 “release” with backdating to October 15.  Reason #15 to always bill for things even if you don’t …

FluMist Twofer

I have two you’ll-see-it-here-first-if-not-only reports to provide you about the 2008 RVUs, but I’m reloading my personal machine (new hard drive) and I can’t get to them until Friday. Until then, you have to suffer with this important FluMist news. Why are these news items important? I’ve now seen major advertising or health articles for …

United Modifier Update

I hate parroting things from PedTalk and elsewhere, but this one is big (and it’s a tough week). Straight from Susanne Madden, of course, is an update to a previous important announcement from UnitedHealthCare and the AAP that was made at the SF NCE: United has decided to ‘delay indefinitely’ their implementation of the claim …

More 2008 RVU News (not good for some)

I was in the middle of re-stating these facts when I realized that Linda Walsh said it as well as I could: As you know, CMS once again implemented its work adjuster to allow for Medicare budget neutrality in light of the increases from the last Five-Year Review. For 2008, the adjustment factor increased to …

2008 RVU Updates Out

[Note: Since this post, there are have been major changes to the RVUs. Check more recent posts in this blog, like this one.  You may also want to go directly to PCC’s on-line RVU tools.] First, a sincere thank you to Linda Walsh at the AAP for this update. Linda is like a sharp dagger …

Vaccine Showdowns (Go EBP!)

My apologies to the readers of the SOAPM mailing list, as this is a repeat, but there are too many folks who would otherwise miss this piece from the San Francisco Chronicle: Doctor-insurer disputes force parents to pay up front for shots It’s the children who feel the sting of vaccinations, but it’s their parents …

Imms Admin (90465 vs. 90471)

For some time, we have known that our customers who use the “new” imms admin codes tend to get paid better for them. We figure, just as Dr. Bradley stated at the PCC-sponsored Coding event in NYC recently, that many of the MCOs simply entered the new codes with the new values but didn’t update …