The Centers for Medicare & Medicaid Services has reduced the payment for lithotripsy by approximately 20 percent due to an error in the November 2011 payment rate, according to an ASCA release.
ASCA reached out to CMS and has learned that Medicare contractors are not supposed to automatically reprocess previously paid claims. The ASCA asks providers to please note that the rate provided for CPT 50590 is the national rate and thus does not reflect local wage adjustments.
HCPCS Code
50590
Short Descriptor
Fragmenting of kidney stone
INCORRECT Rate Released November 2011
$2,102.29
CORRECTED Rate Released April 24, 2012 (Rates Retroactive to January 1, 2012)
$1,665.59
% Decrease
-20.77%
Dollar Decrease
-$436.70
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ASCA reached out to CMS and has learned that Medicare contractors are not supposed to automatically reprocess previously paid claims. The ASCA asks providers to please note that the rate provided for CPT 50590 is the national rate and thus does not reflect local wage adjustments.
HCPCS Code
50590
Short Descriptor
Fragmenting of kidney stone
INCORRECT Rate Released November 2011
$2,102.29
CORRECTED Rate Released April 24, 2012 (Rates Retroactive to January 1, 2012)
$1,665.59
% Decrease
-20.77%
Dollar Decrease
-$436.70
Related Articles on Coding, Billing and Collections:
Health Plans Giving Patients Detailed Cost Estimates for Physician Visits
Aetna Program Aims to Increase In-Network Referrals
Illinois Rep Introduces Bill to Require Disclosure of ASC Charges