On July 1, 2015 the American Medical Association (AMA) released its semi-annual update to its list of CPT Category III codes. The AMA identified 34 new Category III codes; these codes all are scheduled to become effective as of January 1, 2016.  Of particular interest to Echocardiographers is 0399T – Myocardial strain imaging as described below:

• 0399T: Myocardial strain imaging (quantitative assessment of myocardial mechanics using image-based analysis of local myocardial dynamics)
  ►(Use 0399T in conjunction with 93303, 93304, 93306, 93307, 93308, 93312, 93314, 93315, 93317, 93350, 93351, 93355)◄
  ►(Report 0399T once per session)◄

Reminders for your practice

1. Typically Category III codes replace unlisted codes that were previously used for new procedures or services.   Prepare to update your charge sheets.
2. If a Category III code describes the procedure or service performed, it must be reported. An unlisted code or less specific Category I cannot be reported in place of an active Category III code.
3. Reimbursement of Category III codes is at the discretion of payers.  During the six months between announcement of new Category III code and active date, practices interested in utilizing new code should begin working with local payers to obtain coverage and payment.
4. Category III codes are released on a semi-annual basis in January and July and are published on the AMA’s website.  Please reference the AMA website for a complete listing of all recently approved Category III codes

Also, with the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACA) Congress permanently repealed and replaced the Sustainable Growth Rate Formula and a providing to increase the Medicare conversation faction by .05%. This increase will go into effect today, July 1.

This week, US CMS has published the third annual release of the Medicare hospital utilization and payment data (both inpatient and outpatient) and the second annual release of the physician and other supplier utilization and payment data. As they did last year, state and national media outlets are expected to publish names and details of top billers in forthcoming coverage of this year’s data.

CMS files can be searched by specialty or by state which allows you to compare yourselves to your peers. For more information please visit here.

As always, ASE will monitor press coverage of this data release in the coming weeks, and will continue to alert our members if any articles emerge that are particularly concerning for echocardiography.