Hammon Marilyn
J Okla State Med Assoc. 2005 Jan;98(1):27-9.
Part I of this series will highlight several changes in coding and billing for 2005. Medicare has established new preventive medicine services and screening tests for beneficiaries, but they have certain qualifications and documentation rules that must be followed. New codes have been established for using the Internet or similar electronic communications in response to a patient's request. There are additional revisions for pediatricians, orthopedists, endoscopists and surgeons performing transplants and bariatric surgery. All new CPT codes must be activated and deleted codes must be discontinued effective January 1, 2005. From that date forward, the patient's date of service must reflect current diagnosis (ICD-9) and procedure/services (CPT and HCPCS) codes. The Health Insurance Portability and Accountability Act (HIPAA) mandated a January 1, 2005, date compliance for all new and deleted diagnosis (ICD-9-CM) and physician service codes (CPT and HCPCS). Physicians no longer are allowed the 90-day grace period to update their coding systems to reflect the changes. The new 2005 CPT book contains many revisions within the codes themselves along with revisions found in the specific "guidelines" at the beginning of many sections. The CPT codes for 2005 contain 26 deleted codes and 130 new codes, thus providing a challenge to update all coding systems by the January 1, 2005, compliance date for CPT codes.
本系列的第一部分将重点介绍2005年编码和计费方面的若干变化。医疗保险为受益人设立了新的预防医学服务和筛查测试，但它们有一些必须遵循的资格和文件规定。针对应患者要求使用互联网或类似电子通信的情况，已设立了新的编码。对进行移植手术和减肥手术的儿科医生、骨科医生、内镜医生和外科医生的编码也有其他修订。所有新的现行程序编码（CPT）必须启用，已删除的编码必须在2005年1月1日起停用。从该日期起，患者的服务日期必须反映当前诊断（国际疾病分类第九版，ICD - 9）以及程序/服务（现行程序编码和医疗保健通用程序编码系统，CPT和HCPCS）编码。《健康保险流通与责任法案》（HIPAA）规定所有新的和已删除的诊断（ICD - 9 - CM）以及医生服务编码（CPT和HCPCS）必须在2005年1月1日符合规定。医生不再有90天的宽限期来更新其编码系统以反映这些变化。2005年新的现行程序编码手册在编码本身以及许多章节开头的特定“指南”中都有许多修订。2005年的现行程序编码包含26个已删除编码和130个新编码，因此要在2005年1月1日现行程序编码的合规日期前更新所有编码系统是一项挑战。
