AAAAI Advocacy Impacts ICD-10 Codes for Reimbursement Since the transition to ICD-10 coding on October 1, 2015, AAAAI leadership has contacted several of the Medicare Area Contractors (MAC) to request diagnosis code revisions to the MAC's Local Coverage Determinations (LCD). Several diagnosis codes which were previously approved for medical necessity have been omitted from the ICD-10 list of diagnosis for allergy testing and allergy immunotherapy. LCD policies in question include: Novitas LCD 36240 and LCD 36241, and National Government Services LCD 32553.
From correspondence with Wisconsin Physician Services (WPS) regarding LCD 34597, WPS recently informed AAAAI leadership that codes from T63.421A to T63.464S will be retroactively reimbursable to October 1, 2015. In addition, as a result of the AAAAI's request for review, First Coast Service Options notified leadership that (L33804) allergen immunotherapy will be revised to include the entire range for toxic effect of venom diagnosis codes (T63.001A-T63.94XS) in the section "ICD-10 Codes that Support Medical Necessity" for CPT codes 95115 and 95117. These modifications to the LCD and updates to the system will be made over the next several weeks. Reimbursements will be made for the date of care provided, or on or after October 1, 2015.
Novitas is expediting the AAAAI's request for review, and will update its website regarding LCD 36240 and LCD 36241. If revised, ICD-10 code updates will be retroactive to October 1, 2015. A response from National Government Services is pending.
2016 Physician Fee Schedule Update As you previously read in October Practice Matters, the AAAAI signed on to two collaborative letters around important issues in the CMS 2016 Physician Fee Schedule, in addition to submitting a letter of our own. These letters are available on the advocacy webpage. The results in the final 2016 Physician Fee Schedule rules were mixed for the specialty. We were disappointed to see core A/I codes still included on the potentially misvalued codes list, but very pleased to see few changes to the rules for Quality Clinical Data Registries like the AAAAI
QCDR. Analysis of the payment and quality provisions prepared by Hart Health Strategies are available for your review below.
AAAAI Holds School-based Management for Asthma Summit, White Paper Coming The School-based Management for Asthma Summit, sponsored by the AAAAI with additional support from the National Association of School Nurses (NASN), took place October 8-10 near Washington, DC. The Summit is part of a larger initiative of AAAAI President Robert F. Lemanske, Jr., MD, FAAAAI, to improve the care of asthmatic children within the school setting. Participants included over 40 stakeholders from various lay and professional organizations who have relevant interest or expertise, or have developed programs that relate to the school-based management of asthma. The focus is now on creating a white paper that will summarize recommendations for future achievement of the goals and action items that were developed and formalized during the Summit. The paper is expected to be published by April 1, 2016.
-Practice & Policy Matters-
Auvi-Q Nationwide Recall Sanofi US has issued a voluntary nationwide recall of Auvi-Q® (epinephrine injection, USP) due to potential inaccurate dosage delivery. The concern is that if a patient was experiencing anaphylaxis and ended up not receiving the intended dose, there could be significant implications due to the potentially life-threatening nature of anaphylaxis. The recall covers all Auvi-Q units currently on the market in both the 0.15 mg and 0.3 mg strengths. This includes lot numbers 2081278 through 3037230, which expire October 2015 through December 2016.
Now Available: New Primary Immunodeficiency Practice Parameter Brush up on your knowledge of primary immunodeficiency disease with a newly updated practice parameter titled, "The Diagnosis and Management of Primary Immunodeficiency." The practice parameter was developed by the Joint Task Force on Practice Parameters and has been published in The Journal of Allergy and Clinical Immunology (JACI). Share this document with your colleagues to encourage wider recognition of primary immunodeficiency, increase uniformity and efficiency in evaluation, and enhance application of specific diagnoses.
How is Healthcare Information Technology Working in Your Practice? With the recent release of Stage III requirements for the CMS Meaningful Use program, there is considerable discussion at the national level regarding the challenges of electronic health record implementation and other technology in physician practices. The Healthcare Information Management Systems Society (HIMSS) has asked the AAAAI to invite our members to participate in a survey gathering information on the value and use of healthcare information technology in practice. The AMA has also asked the AAAAI to invite our membership to participate in a survey regarding the summary of care document that is produced to meet the Transfer of Care objective in Stage II of Meaningful Use.
Looking for past issues of Practice Matters? An archive is available at: aaaai.org/practicematters
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