From time to time, MSP releases broadcast messages that contain updated information on billing processes, guidelines or fee codes. Typically, these messages contain updated information on fee codes, either in their description or the amount that they pay.
While these messages tend to be short and to the point, sometimes they can be confusing or unclear. Nevertheless, it’s important to stay up-to-date since they usually affect your pay and what you’re eligible to bill or not.
In the month of November, MSP released 5 broadcast messages. In case you missed them, here’s a summary of those announcements:
1. Six Radiology Fee Codes have been Cancelled
Effective November 30th, 2019 MSP has discontinued the following 6 radiology fee codes:
08712: Radiology consult for malignant lesion of skin, $28.87.
08711: Radiology consult for malignant lesion – w/ biopsy, $43.26.
08710: Consult malignant haemopoietic/reproductive/etc., $57.46.
08772: Telehealth radiology consult/malignant lesion skin, $28.87.
08771: Telehealth radiology consult malignant w/biopsy, $43.26.
08770: Telehealth radiology consult for malignant lesion, $57.46.
2. Retroactive Payment on Out-of-Office Hours Premiums
On April 1st, 2019 MSP increased the amount that out-of-office premiums pay. However, it wasn’t until this past month that retroactive payments for the increase were paid out. They should shown up on your November remittance under adjustment code 80.
Here are the out-of-office premiums that increased:
Call-Out Charges
01200: Call-Out Charge, Evening (between 1800-2300)
$71.86 (previously $60.96).
01201: Call-Out Charge, Night (2300-0800)
$100.92 (previously $85.62).
01202: Call-Out Charge, Saturday, Sunday or Statutory Holiday
$71.86 (previously $60.96).
Non-Operative Continuing Care Surcharges
01205: Surcharge (1800-2300) – Nonoperative, per half hour or major part thereof
$66.08 (previously $56.06).
01206: Surcharge (2300-0800) – Nonoperative, per half hour or major part thereof.
$90.34 (previously $76.64).
01207: Surcharge, Saturday, Sunday or Statutory Holiday- nonoperative, per half hour or major part thereof.
$66.08 (previously $56.06).
Operative Continuing Care Surcharges
01210: Evening (1800 hours to 2300 hours) 44.46% of surgical (or assistant) fee (previously 38%)
-
Minimum charge $64.27 (previously $53.38)
-
Maximum charge $443.35 (previously $376.11)
01211: Night (2300 hours to 0800 hours) 71.37%of surgical (or assistant) fee (previously 61% )
-
Minimum charge $90.25 (previously $74.98)
-
Maximum charge $.622.60 (previously $517.16)
01212: Saturday, Sunday or Statutory Holiday. 44.46% of surgical (or assistant) fee (previously 38%)
-
Minimum charge $64.27 (previously $53.38)
-
Maximum charge $443.35 (previously $376.11)
Reminder: You can’t bill a Call-Out Charges or Continuing Care Surcharges if you’re scheduled to work nights or weekends, or even if you’re on-call. You are only eligible when called out to the hospital on an urgent, non-elective basis.
Medical billing in BC is confusing and can often be overwhelming. To help out, check out our complete MSP guide that walks you through each step of medical billing – from the general teleplan process to maximizing your claims and using mobile billing.
3. Retroactive Payment for Osteopaths
The 9 Osteopaths fee codes below were increased back on April 1st, 2019. Retroactive payment for claims previously paid at the old rate have now been processed.
00270: Osteopathy-for an initial office visit (age 0-69).
$50.25 (previously $45.14).
00271 Subsequent visit including manipulation (age 0 – 69).
$36.41 (previously $35.43).
00272: Osteopathic consultation, in or out of office (age 0 – 69).
$100.92 (previously $98.20).
00273 Non-referred initial visit including manipulation (aged 70 plus).
$60.32 (previously $53.99).
00274 Subsequent visit including manipulation (aged 70 plus).
$45.52 (previously $44.30).
00275 Osteopathic consultation, in or out of office (aged 70 plus).
$121.16 (previously $117.90).
00276 Prolonged visit and/or counselling for complex case (aged 70 plus).
$63.39 (previously $61.69).
00277 Prolonged visit and/or counselling for complex case (aged 70 plus).
$79.26 (previously $77.13).
00279 Osteopathic Complex Care Management Fee. This can only be billed once a year in combination with (and on the same calendar date as) fee item 00276 or 00277.
$131.78 (previously $128.26).
4. Retroactive payment for Emergency Medicine
The 4 emergency medicine fee codes below were increased back on April 1st, 2019. Retroactive payment for claims previously paid at the old rate have now been processed.
Level I Emergency Care
01841: Saturday, Sunday, or a Stat holiday.
$44.44 (previously $42.97).
Level II Emergency Care
01842 – Saturday, Sunday, or a Stat holiday.
$93.17 (previously $89.96).
Level III Emergency Care
01843 – Saturday, Sunday, or a Stat holiday.
$115.97 (previously $112.03).
5. Two New General Surgery Updates
1). Fee item 70124 now includes the word ‘ear’ in its description.
70124: Local Tissue Shift
Description: Local tissue shift, eyebrow, eyelid, lip, ear, nose (single).
$292.94.
Billing Tip: Don’t bill this for a repair of a torn earlobe, your claim will be rejected, instead use 06027 (Skin graft; repair of torn, split, earlobe -simple).
2. 72654 and 72684 eligible for BMI premium
Fee codes 72654 (Fistula – Closure/Bowel Resection) and 72684 (Fistula Closure/Bowel Resection LAP) are now eligible for the BMI premium if your patient has a BMI (Body Mass Index, which is the estimate of your patient’s body fat based on their weight and height) greater than 35.
The BMI Premium pays 25% of the fee for surgery. Example:
| Fee Code Amount | BMI Premium Amount |
|---|---|
| 72654 ($401.34) | BMI ≥ 35 (25% = $101.08) |
How to bill the BMI premium
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Create a claim like you normally would selecting the fee code for the surgery you performed (example: 72654).
-
Create a second claim for the BMI premium using fee code 07003.
Reminder: While this premium is listed at $2,008.00, the amount varies depending on the surgery, as it only adds an additional 25% of the surgery amount. In our example adding the BMI premium to the 72654 results in an extra $101.08.
On Dr.Bill, once you’ve added both claims the 25% BMI premium is automatically calculated. You can check this by going to the claims calendar on the app and selecting the DOS.
You’ll see the surgery fee code along with the BMI premium at the 25% amount .
The general surgery fee codes below are eligible for the BMI premium when your patient has a BMI greater than 35.
For a quick way to search through them use our
General Surgery Searchable Database.
07134, 07360, 07363, 07366, 07368, 07402, 07403, 07404, 07405, 07406, 07407, 07408, 07409, 07410, 07411, 07412, 07413, 07431, 07432, 07433, 07434, 07435, 07436, 07437, 07438, 07440, 07441, 07442, 07443, 07444, 07445, 07446, 07447, 07448, 07449, 07450, 07451, 07452, 07455, 07474, 07475, 07479, 07565, 07566, 07567, 07569, 07570, 07578, 07580, 07588, 07589, 07596, 07597, 07600, 07601, 07603, 07610, 07623, 07624, 07626, 07627, 07628, 07630, 07632, 07633, 07634, 07635, 07636, 07640, 07641, 07643, 07645, 07646, 07647, 07648, 07649, 07650, 07651, 07654, 07655, 07658, 07660, 07662, 07663,
07664, 07672, 07698, 07699, 07703, 07705, 07706, 07707, 07711, 07714, 07732, 07733, 07756, 07758, 07764, 07769, 07776, 70024, 70025, 70501, 70503, 70504, 70505, 70506, 70509, 70511, 70531, 70532, 70533, 70534, 70535, 70536, 70538, 70539, 70540, 70541, 70542, 70544, 70601, 70602, 70603, 70604, 70605, 70606, 70607, 70620, 70621, 70622, 70624, 70625, 70626, 70627, 70628, 70629, 70630, 70631, 70632, 70633, 70635, 70641, 70646, 70648, 70649, 70650, 70651, 70660, 70661, 70665, 70666, 70668, 70670, 70671, 70672, 70694, 70695, 70696, 70698, 70700, 70701, 70702, 70703, 70704, 70705, 70710,
70711, 70712, 70713, 70714, 70715, 70716, 70717, 70718, 70720, 70721, 70722, 70725, 70726, 70727, 70728, 70730, 70731, 70748, 71290, 71291, 71292, 71293, 71380, 71535, 71536, 71537, 71538, 71539, 71540, 71541, 71542, 71543, 71544, 71546, 71547, 71549, 71551, 71606, 71607, 71608, 71609, 71610, 71611, 71612, 71613, 71614, 71615, 71616, 71617, 71618, 71619, 71620, 71621, 71622, 71623, 71624, 71625, 71650, 71651, 71698, 71700, 71703, 71704, 71705, 71708, 71709, 71710, 71712, 71713, 71714, 71715, 71716, 71717, 71718, 71719, 71720, 71721, 71722, 71725, 71747, 72572, 72600, 72601, 72620,
72621, 72622, 72623, 72624, 72625, 72626, 72631, 72632, 72633, 72634, 72635, 72636, 72640, 72641, 72644, 72645, 72646, 72647, 72648, 72650, 72651, 72652, 72653, 72654, 72656, 72657, 72658, 72659, 72660, 72662, 72664, 72665, 72666, 72667, 72669, 72670, 72671, 72672, 72673, 72683, 72684, 72703, 72704, 72705, 72713, 72714, 72715, 72720, 72721, 72723, 72725, 72726, 72727, 72728, 72729, 72730, 72731, 72732, 72733, 72734, 72735, 72736, 72737, 72740, 72741, 72745, 72751, 72755, 72760, 72762, 72763, 72765, 72767, 72769, 72770, 72775, 72788, 72789, 72794, 72795, 72796, 72797, and 72798.
Broadcast messages are important but often overlooked, make sure you always stay up-to-date so you’re aware of any MSP fee code changes, increases or decreases.
If you have questions about any of the November updates, please reach out to our billing team and we’ll be able to help.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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