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News -> November, 2001 News
Frederick A. Kuhn, M.D.
ARS Immediate Past President
Georgia Nasal & Sinus Institute
Savannah, GA
It has been a great honor and privilege to serve as your president over the past year. I thank-you for the opportunity. I leave you in extremely capable hands as Paul Toffel, who has put on two superb meetings in the past year and who has developed our corporate Sponsors program, takes over as President of the Society. Don Lanza as President Elect will be in charge of the spring and fall scientific programs, which promise to be excellent.
As I told the board of directors, this position seems to take on a life of its own dictated by circumstances, which this year seems to have been largely economic. What a surprise! CPT code # 61795 was approved for use with sinus surgery in time to be published in the 2000 CPT CodeBook. Administar on behalf of HCFA then made a coding edit disallowing the use of this code with most sinus surgery after September 1, 2000. We approached our attorneys in Washington, DC, Hogan & Hartson, who developed a response to HCFA and Administar funded by your dues, which we submitted jointly with the Dr. Richard Holt, EVP of the Academy. Dr. Niles Rosen of Administar responded very positively to us in a letter, which we published in the last ARS newsletter in Dr. FriedŐs report. All denied claims for 61795 could then be reprocessed after January 1, 2001.
Beginning in mid February 2001, local Medicare carriers again began denying claims for "Stereotactic Computer Assisted Navigation" (CPT 61795) performed in conjunction with sinus surgery, claiming that it was an add-on code for neurosurgical procedures only. We went back to Ms. Beth Roberts and Ms. Laura Loeb of Hogan & Hartson in Spring 2001 who recommended that we ask the AMA CPT coding section for a letter of clarification, which could be used to support our position with the carrier medical directors. This letter from Grace Kotowicz very clearly delineates the AMAŐs intent for the code's use with sinus surgery and can be found on the ARS web site along with the Dr. Rosen's letter from Administar. These efforts are a very tangible benefit of your Society dues, which we hope are beneficial to your practice and your continuing struggle with managed care.
Two other items of importance are 1) to warn you of the new HIPPA regulations (Health Insurance Portability and Privacy Act), which are in effect. Compliance is required by early 2002. This Act is mostly about information privacy and has very little to do with health insurance portability. The second is about Managed care companies' bundling and downcoding your claims. If you are having problems with this I suggest that you contact Dr. Joe Leonard in Oklahoma City, the new Board of Governors Chairman. He can put you in touch with people to help.
Thank you again for the opportunity to serve as your President.
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