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A little while ago, someone bravely asked to see 99174 usage data among pediatricians.
For those who aren't family, the 99174 is new in 2008. To quote the CPT book (but not enough to attract the ire of the AMA), the 99174 is "Ocular photoscreening with interpretation and report, bilateral."
So, waltzing into the massive PCC database, we find...no instances of the 99174 among our clients. None, zippo, nada. That doesn't help! Therefore, I turn to the new poll on the left. Anyone here using the 99174? Getting paid? Tell us more. The code itself is scheduled to get more/better RVUs in 2009, so perhaps it's time to pay attention.
It's not too soon to look ahead to 2009 to see what's in store for pediatricians as a result of the CMS machinations. I've ignored, as you can see, the drama over the last few weeks related to the scheduled Medicare fee cuts - there are plenty of places you can find that news. However, I have the opportunity to share some notes to the AAP's Coding and Nomenclature Committee about what they are seeing. I've edited or reduced the information and highlighted some important (to me) points, so please blame just me for any miscommunication, etc.
The clinical staff time in question includes time spent entering data into an immunization registry, logging temps, etc. Given that this time demand has exploded for some offices, it's pathetic that CMS doesn't understand what these practices are going through.
I want to see if I have this right: because the AMA wants to protect its ridiculous CPT copyright (including the non-copyrightable RVU values), its own members - and the affected public - cannot actually learn what our government is going to do with some federally mandated codes until the AMA has time to publish its book. I can't believe that this was in the spirit of the copyright law when it was written and I have a hard time believing it's actually in the letter of the law, either. Someone lend my the $500K+ it would take to fight that lawsuit and I'll get right on it. The money the AMA receives from their licenses ($70m/annually, when they last told me) is worth more to them than doing the right thing.
Enough of my ranting. I have to go prep for CCHIT. What can a lowly pediatrician do? Make sure your contracts are locked into a specific year of the RVUs. I prefer 2005->2007, myself.