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TOA
Executive Director's
Update
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By Donna Parker
Executive Director, Texas Orthopaedic Association
TOA
receives many questions regarding coding and billing. Not
being a billing and coding specialist, my usual response to
a question will be “let’s call the experts.” We thank
Teresa Devine, TMA
Director of Payment Advocacy, (800) 880-1300, ext. 1415,
(512) 370-1415
for answering this question on fluroscopy billing. |
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Question:
Our office is considering purchasing a fluroscan and I’m trying to
gather billing information for fluroscopy procedures. Will insurance
carriers allow us to bill for fluoroscopy performed in an office
setting? The company has provided us with carrier reimbursement
information, but I’d like to verify its accuracy as far as collecting
is concerned.
Answer:
The most efficient way to collect this info is to check the on-line
medical policies of your major contracted health plans. Often you can
search by CPT code or text. If there are no medical policies, then you
might also want to check on whether this service will be bundled if
provided with another procedure, certainly checking CCI is a good
idea. There are different CPT codes for fluroscopy depending on what
you are using it for, so you'll want to check those that apply
specifically to the procedures you plan to be performing.
AAOS also offer
billing and coding information. You can send your questions to AAOS
staff by clicking
here.
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TDI-DWC, News Releases
Concerning PRM and Treatment Planning Rules
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The Texas Department of Insurance, Division of Workers' Compensation
has announced that repeals of two workers' compensation rules will be
submitted to the Texas Register. The rules are the Prospective Review
of Medical Care Not Requiring Preauthorization (PRM) rule and the
Treatment Planning rule.
The PRM rule is no longer needed due
to the adoption of treatment |
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guidelines for the
workers' compensation
system. To view the news release concerning PRM, please
click
here.
The treatment planning rule was adopted last December as one
of several disability management rules but the effective
date was postponed due to concerns expressed by system
participants. The repeal of the treatment planning rule will
not affect the other disability management rules including
those adopting treatment and return-to-work guidelines for
Texas. To view the news release concerning treatment
planning, please click
here.
We encourage you to forward this email to a friend or
colleague who participates in the Texas workers'
compensation system.
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This Week In Texas: Mignon
McGarry Memos
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By Mignon McGarry
TOA Legislative Advocate / Memos: Tuesday June 12, 2007
TOA Online Version: All Memos
June 12,
2007, Tuesday
So far, the Governor has vetoed two
bills, HB 1892
relating to the authority of certain counties and other
entities with respect to
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transportation projects and
HB 770 relating to
requiring the Texas Department of Criminal Justice to provide notice
to certain persons regarding the right to vote. The Governor has
signed 260 bills and allowed four bills to become law without his
signature.
A week from today, you will receive a full
account of vetoed bills.
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Workers’ Compensation Physician Practice Update
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By Michael Reed
TMA Director of Managed Care Delivery Systems
List of Articles in this update include: |
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TDI –
DWC Invites Stakeholders To Meeting in Austin to Discuss Important Comp
Issues
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TDI
Memo to Physicians Addressing Carrier Denials for Medical Bills Not
Timely Filed
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Prospective Review of Medical Care (PRM) Rule to be Repealed
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Stakeholders Divided on Next Cycle of Provider Fees from Workcompcentral
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Prospective Review Rule Scrapped
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DWC
Medical Adviser Warns Providers, Carriers on Over-Use
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Approved Doctor List (ADL) is going away 9-1-2007 - TDI addresses the
issue of Providers on the Approved Doctor List
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Training Offerings
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TMA
will be offering workers’ compensation education seminars in August and
September – more information coming soon!
To view all these articles, please click
here.
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Texans Bringing Five Proposals
To AMA
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Based on actions
by the TMA House of Delegates in April, the Texas Delegation to the
American Medical Association is bringing five resolutions to the AMA
House of Delegates meeting, June 23-27, in Chicago.
The Texas
resolutions call for AMA action or would set new AMA policy
on issues ranging from the health of pregnant women and compensation
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for physicians' emergency room coverage to scope of practice, physician
licensure, and substance abuse. Read summaries of the five measures, or
the detailed resolutions, on our new summer blog, “Texas
in Chicago in June.” We’ll update all the pre-meeting news, keep you
posted throughout the event, and throw in a few surprises.
You can read
it
on the Web or subscribe via
RSS feed.
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