Cpt - 2012

[lossnwilderness]

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I read this on another msgboard. Any thoughts from those of you out there in the real world?

CPT 2012 - The year PM&R gets whacked

This is a summary of CPT changes that affect PM&R and Pain this year:

SI joint injections (27096) cannot be billed with US. You could possibly bill as large joint with US. Fluoro now bundled with 27096.

Epidurals (62310-11) now include the injectate and contrast - they are bundled with it.
Facet joint RFA has been changed. Old codes (64622 - 64627) deleted, new ones (64633-64636) in place. You now bill by facet level, instead of per nerve, meaning at least 1 less unit billed per procedure, and fluoro is now bundled with it. Loss of 40% or more of payment for the same procedure.

EMG coding altered. When doing EMG and NCS on same day (as you do in 99% of cases probably), there are new codes (95855-95887) to use for the needle exam instead of old ones (95860-95864, 95867-95870). While this is not supposed to alter the payment for these codes, it is expected that by next year, the needle exam will be bundled with the NCS.

I think if CMS just kicked me in the balls instead, I would be happier.

Happy New Year!

 

[PMR 4 MSK]

I'm told that the RVUs for the new EMG codes are lower than the old ones as well.

I anticipate a 10% or greater decrease in collections this year due to the above.

Fluoro is bundled with most everything now but interlaminar ESI. This is probably only because of surgical anesthesia. If they ever develop a seperate code for CESI or LESI, different than surgical epidural, I'm sure they'll bundle fluoro with that as well.

So now you need to have that $100K fluoro unit to do procedures, but they won't pay you to use it.