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Home » Coding & Reimbursement
Coding & Reimbursement
The American Academy of Audiology is committed to keeping you informed of the latest developments in coding and reimbursement, and providing you with comprehensive resources on a range of health care issues. In doing so, the Academy uses a variety of resources and mechanisms on our Web site to ensure that you receive complete and easy-to-understand information on coding and policy changes, as well as ongoing initiatives that affect billing and payment of audiology and vestibular services. We are confident that the tools and resources found on the following sites will prove to be valuable resources.
News and AnnouncementsNPPES to Undergo Maintenance on April 21, 2008
(4/17/08) On April 21, 2008, the National Plan and Provider Enumeration System (NPPES) will undergo system maintenance that day only and you will not be able to obtain your NPI, access the NPI registry, nor obtain your file. Read the full story.
CMS 855 Enrollment Forms Have Been Updated
(4/17/08) If you have already filed these forms, there is no need to refile unless your PIN is inactive. For those who have not filed these forms, read the full story and get the links for the most up-to-date provider enrollment forms. Read the full story.
American Academy of Audiology Conducting Physician Practice Information Survey
For the first time in nearly a decade, the American Academy of Audiology (Academy) and more than 70 other health care professional organizations have worked together to coordinate a comprehensive survey of America’s audiology practices. The survey will collect up-to-date characteristics of thousands of practices from virtually all disciplines, and be used in efforts to positively influence national decision-makers to ensure accurate and fair representation for all health care professionals and patients.
Getting our nation’s policy-makers to understand today’s landscape and the requirements for care is critical. This data will allow the health-care community to articulate the challenges of running a practice that provides expert patient care, while operating a business that is sustainable. The study results will not only help in the short-term but will allow future generations of audiologists to continue providing superior care to their patients.
One particularly important section of the study pertains to practice expenses and the amounts that are attributable to you. The Centers for Medicare and Medicaid Services have indicated that the results of this study will be used to help determine Medicare payment. Please encourage your staff to make this information available, as the survey’s success depends on accurate and complete data. This information will remain confidential. The survey firm, Dmrkynetec, will not identify any individuals or entities participating in this research.
Dmrkynetec, a survey firm with extensive experience in the area of health-care finance, has been retained to administer the survey. Dmrkynetec will contact randomly selected audiologists and practice managers to collect their confidential responses. Please watch for this survey and complete it thoroughly and accurately. Do your part to represent our profession.
Frequently Asked Questions about the Survey (FAQs)
Canalith Repositioning Procedure Submitted for Consideration at the CPT Editorial Meeting
The American Academy of Audiology has submitted the Canalith Repositioning Procedure (CPT code 959XX) for consideration at the recent CPT Editorial meeting in conjunction with the American Academy of Neurology, the American Academy of Otolaryngology-Head and Neck Surgery, the American Speech-Language-Hearing Association, and the American Physical Therapy Association.
The next step in this valuation process is for the code to be valued for physician work by the Relative Value Update Committee (RUC). "Physician work" is one of the components of the Relative Value Unit (RVU) that determines the amount of reimbursement for a code. The survey process will begin on Friday, February 29, 2008 with a completion date of March 14, 2008.
For those of you who perform CRP in your practice and would like to add your critical input to this process, please send your name and e-mail address to Debbie Abel, Director of Reimbursement at dabel@audiology.org by the close of business on February 27th. A cover letter and an e-mail with the address of asha.org@softekdc.org granting access to the survey will be sent to you by February 29th. Thank you for helping the Academy and the above listed organizations provide the reimbursement recognition for the treatment of our BBPV patients!
Medicare Physician Fee Schedule Final Rule Assigns Work Values for Audiologists
Audiologists will receive a 2% increase in aggregate Medicare payments in 2008 according to the Medicare physician fee schedule rule released yesterday, November 1 by the Centers for Medicare and Medicaid Services (CMS). Read the full story here.
Academy Invited to Present to CMS Multi-Specialty Refinement Panel Meeting
The Academy was invited to represent the specialty of audiology in a Centers for Medicare and Medicaid Services (CMS) multi-specialty refinement panel meeting held on October 4, 2007, as a direct result of comments submitted to the CMS on the CY 2008 Medicare Physician Fee Schedule Proposed Rule. Read the full story here...
The NPI Registry is Now Available Online!
The NPI Registry and the downloadable file are now available. View the registry on the web or access the downloadable file. More information and education on the NPI can be found through the CMS NPI page on the CMS web site. Providers can apply for an NPI online or can call the NPI enumerator to request a paper application at 1-800-465-3203.
Important Provider Information on National Plan and Provider Enumeration System (NPPES) Data Elements Data Dissemination
The NPPES Data Dissemination Notice (CMS-6060-N) was published in the Federal Register on May 30, 2007. The Notice describes the policy by which CMS will make certain NPPES health care provider data available to covered entities under the Health Insurance Portability and Accountability Act (HIPAA) and to others. Please visit the CMS website for more information.
CMS Announces 12-Month Contingency Plan for NPI Compliance
On April 2, 2007, the Centers for Medicare & Medicaid Services (CMS) announced that it is implementing a contingency plan for covered entities (other than small health plans) who will not meet the May 23, 2007, deadline for compliance with the National Provider Identifier (NPI) regulations under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Click here to learn more.
Medicare Update on Revised 1500 Health Insurance Claim Form
In July 2006, the National Uniform Claim Committee (NUCC) released the revised version of the 1500 Health Insurance Claim Form, primarily for the purpose of accommodating the National Provider Identifier. Since that time, the industry has been preparing for the implementation of the revised version of the form. In September 2006, Medicare announced that it would implement the revised form on January 1, 2007 with dual acceptability of both versions until March 31, 2007. Medicare further announced that beginning April 1, 2007, the revised version would be the only acceptable form and that the prior version would be rejected. CMS has extended this deadline. Click here to learn more.
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