Clarification of CMS’ proposal for multiple procedure payment reduction

The Advocacy Council has heard from many allergists who are concerned about the impact of the Center for Medicare and Medicaid Services’ (CMS’) proposal in the 2019 Physician Fee Schedule to implement a payment reduction of 50% on one service when it is provided with another service during the same encounter.  We want to clarify that this proposal applies primarily to codes with a global period and does not apply to any of the skin testing, spirometry, or Xolair administration codes.

Based on our research, only a small number of services that are only occasionally billed by allergists would be impacted. They include CPT 31231 – Nasal endoscopy; CPT 69210 – Remove impacted ear wax; and CPT 31575 – Diagnostic laryngoscopy. 

The Advocacy Council is submitting comments to CMS on the proposed rules and will keep you informed of all updates as they become available.

Advocacy Issue: 
Billing, Coding & Payments