CMS Announces MUE Proposal Will Be Withdrawn

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RyMcQ

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Here is the text of an email I just got from the CAP. Everyone can stop crapping their pants now.

At a meeting today of the Physician Payment Advisory Commission (PPAC), CMS officials said that the current Medically Unbelievable Edits (MUE) proposal is no longer scheduled to be implemented in July as previously planned. The proposal will be revised and re-submitted for public review and comment. This announcement followed concerns raised by the Chairman of the Physician Payment Advisory Commission Dr. Ronald Castellanos who stated that the current edits could have significant negative impacts on patient care. Testifying before the Commission was Dr. William Rogers, who stated that he had learned about the problems with the current MUE proposal from the College of American Pathologists in a meeting last week. He had discussed these concerns with the MUE Project manager at CMS.

The PPAC recommended "the CMS withdraw the proposal to create a list of MUEs and resubmit through the normal rulemaking process and to work closely with the medical community in this effort." The motion was unanimously accepted.

The CMS decision to withdraw the MUE proposal comes in direct response to an intense lobbying campaign by a CAP-led coalition of national and state pathology societies. The AMA, numerous medical specialty societies, and the American Clinical Laboratory Association (ACLA) also strongly advocated for the withdrawal of the MUE proposal.

The College and its coalition partners have pressed CMS to withdraw the MUE proposal and have argued that the agency should be required to utilize the formal rulemaking process to develop sweeping unit of service limits on all pathology and clinical laboratory services. The College has also asked the agency to provide the rationale and methodology utilized to develop the MUE proposal.

Since CMS' decision in fall 2004 to move forward with cytology PT, the College has argued strenuously for a review of the program, saying improvements in cytology science and practice have long since passed by the PT regulation's 13-year-old grading scheme. The College also contends that various other aspects of the PT program, including its emphasis on individual testing, annual schedule and escalating penalties, conflict with either the letter or spirit of the original CLIA law.

The new approach will hopefully yield a more rational proposal and will also allow medical societies sufficient time to provide a strong evidence based response to whatever proposal may re-emerge.

We are awaiting a written notification from the contractor withdrawing the proposal. CAP will continue to keep members informed on further details of CMS's plans in this area.


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All my prayers to baby Jesus have been answered. I was planning to launch a porn career if I lost my business due to this. :thumbup:
 
LADoc00 said:
I was planning to launch a porn career if I lost my business due to this. :thumbup:
Hey, why let this bit of good news hold you back? :)
 
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Thanks for posting this - the billing system for path is a bit odd though. I find it strange how certain specimens are coded. Bone Marrows, for example, are 88305 yet a bone biopsy is 88307. A 10 cm lipoma is technically an 88304 even if you have to submit 10 blocks. A neck dissection submitted as one specimen is an 88307, whereas if it is submitted as four separate specimens, each can be called an 88307 because they are regional dissections.
 
yaah said:
Thanks for posting this - the billing system for path is a bit odd though. I find it strange how certain specimens are coded. Bone Marrows, for example, are 88305 yet a bone biopsy is 88307. A 10 cm lipoma is technically an 88304 even if you have to submit 10 blocks. A neck dissection submitted as one specimen is an 88307, whereas if it is submitted as four separate specimens, each can be called an 88307 because they are regional dissections.


i've decided to only gross in and sign out placentas when i'm finished w/my training...
check out what you guys code for 'em..out here, they're a gold mine (307 or 305 i believe..but still, just for 3 dinky blocks for chorio v. no chorio?).
 
SLUsagar said:
i've decided to only gross in and sign out placentas when i'm finished w/my training...
check out what you guys code for 'em..out here, they're a gold mine (307 or 305 i believe..but still, just for 3 dinky blocks for chorio v. no chorio?).

Or you just form a practice and find some podiatrists willing to send you specimens when they chunk off bunions or debride osteomyelitis. Then call them all bone biopsies and get 88307 plus 88311 for one cassette.
 
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