Aetna will require pre-authorization for multiple IR procedures starting Sept 1, 2023

As recently reported by the SIR, Aetna has partnered with eviCore to provide prior authorization for the following procedures; cerebrovascular angiography, carotid angioplasty/stent, carotid endarterectomy, TEVAR, endovascular repair of descending thoracic aorta, treatment of abdominal aortic aneurysms, peripheral vascular non-coronary stent procedures, treatment options for saphenous ablation, phlebectomy, sclerotherapy, endovenous ablation, and Iliac vein angioplasty/stenting. […]

Effective July 1, 2023: Reporting for Discarded Drugs – JW vs JZ Modifiers

Effective July 1, 2023, mandatory reporting of all single-use containers as used (JZ Modifier) or wasted (JW Modifier) amounts must be reported on Part B claims. This is part of the Medicare Shared Savings Program Requirements, Drug Waste Accountability Act as part of the 2021 Infrastructure Investment and Jobs Act.

2023 E/M Updates for Consultation Services

The American Medical Association (AMA) published many changes impacting CPT® E/M codes and guidelines, taking effect Jan. 1, 2023. There are 25 deleted codes and many revisions to codes and guidelines in five code categories.

StreamlineMD Releases New Client Portal

We are excited to announce that StreamlineMD will be rolling out new features, allowing you to access security request forms & training videos online through our new StreamlineMD Client Portal. 

Higher Payments for New C-Codes for ASC in 2023

New-C-Codes for ASC

Historically, CMS has created and assigned “C” codes (alpha/numeric) for devices such as drug eluding stents (DES C9600-C9608) and/or hospital billing under HOPPS. For 2023, CMS has created approximately 50 new C codes specifically for billing in the ASC setting, several of which affect coding and billing for some Interventional Radiology and Cardiac Catheterization procedures.

Prepare for MIPS/MACRA 2023

It’s that time again to make sure your practice is on track for reporting MACRA/MIPS for 2023.  Below are some resources to assist you in understanding the MIPS/MACRA requirements for 2023.

2023 Interventional Cardiology CPT Code Changes

The following information details Interventional Cardiology CPT changes for 2023 which may impact your practice. There are nine new Category I codes and three new Category III codes, two of which are add-on codes to the main procedure. Be sure to review below, update or create new report templates, and share with your practice management team(s) in preparation for January 1st in order to avoid billing and reimbursement delays.