susan bauman, bsn, bc iscvpr cardiac reimbursement chairperson
TRANSCRIPT
Reimbursement Rehab
Susan Bauman, BSN, BCISCVPR Cardiac Reimbursement Chairperson
S 382 Bill Text 113th Congress (2013-2014)
S.382.IS“To amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.”
Introduced by Senators Schumer, NY and Crapo, ID, on February 26, 2013
Currently in Finance Committee/ Congressional Budget Office (CBO)◦ Should have no dollars attached for CBO scoring
Access to the Bill information - www.thomas.gov --- enter Bill number
Contact BOTH Senators◦ Phone: ask for person responsible for healthcare issues◦ Email: (sample letter template in handouts)◦ In person: attend a local event with the Senators ◦ Follow up for their decision in about 5-7 days
www.aacvpr.org has made available to all CR & PR professionals:◦ Senate Bill◦ Sample letter to our Senators (need to update)◦ Leave-behind document◦ Senate letter to Dr. Berwick (CMS) and CMS response◦ Communication tips
It’s Time to ACT
Who to contact…
Dan Coats 493 RUSSELL SENATE OFFICE BUILDING
WASHINGTON DC 20510 (202) 224-5623 Contact: www.coats.senate.gov/contact/
Joe Donnelly B33 RUSSELL SENATE OFFICE BUILDING
WASHINGTON DC 20510 (202) 224-4814 Contact: www.donnelly.senate.gov/contact.cfm
KX Modifier An attachment to the CR/PR codes for Medicare clients only
Identify necessity:◦ does the patient know?◦ access the patients Medicare Common Working File (CWF)
Ask your billing, coding departments to assist you
REQUIRED for ALL SESSIONS ABOVE #36 (as a Medicare beneficiary)◦ CMS began tracking 1/1/2010
Example:◦ Jim had a CABG 5/2011, attended CR for 25 sessions. He then had an MI
w/PCI 1/2013 and plans 19 sessions. Jim would need the KX modifier at session #12 of his current rehab program.
◦ Carol had an MI 8/2006, attended CR for 19 sessions. She now is coming to CR after another PCI and plans 19 sessions. Carol doesn’t need the KX modifier.
