305.990 Fair Compensation for Prior Authorization and Appeal of Service Denials MSSNY advocates and requests that upon adoption of CPT codes by the AMA CPT Panel at the May 2024 meeting for payor authorization services and appeals of denied services, the AMA immediately starts advocacy on federal and state levels for legislative mandates for coverage
305.999 Universal Code for Reporting Medical Services and Procedures Performed by New York State Physicians: SUNSET HOD 2013
305.998 HCFA Provision of Coding Information Free of Charge: SUNSET HOD 2014
305.997 ICD-10: SUNSET HOD 2024
305.996 Unknown Diagnosis Coding Under ICD-10 The Medical Society for the State of New York (MSSNY) will ask the Centers for Medicare and Medicaid Services (CMS) to enforce Unknown Diagnosis Coding and ICD-10 Policy with private insurers and managed care organizations, in that such policy is mandatory for all entities covered by the Health Insurance
305.995 Violation of HIPAA Electronic Transaction Standards by Insurer Failure to Upload ICD-10 Revisions The Medical Society of the State of New York (MSSNY) will survey its members asking whether they have experienced claim denials, claims resubmission, or appeals because the insurer (federal, state or commercial) failed to upload the October 1, 2016, version of ICD-10
305.994 ECG/Office Visit Billing Bundle The MSSNY will seek legislation and regulation to prevent insurers from being allowed to bundle an ECG (CPT code 93000) with a visit, when medically necessary. (HOD 2019-259)
305.993 ECG/Stress Test Billing Bundle The MSSNY will seek legislation and regulation to prevent insurers from being permitted to bundle an ECG (CPT cod 93000) with a stress test (code 93015) when these separate procedures are medically necessary to be performed on the same day. (HOD 2019-258)
305.992 Obsolete ICD and CPT Codes The Medical Society of the State of New York (MSSNY) will seek legislation and regulation that would: Provide a grace period where new ICD and CPT codes could be phased in, and Prevent insurers from denying those portions of a claim coded with an obsolete or superseded ICD or
305.991 CPT Codes for Preauthorization Denials and Fair Compensation MSSNY will advocate that the AMA include fair compensation based on CPT codes for appeal of wrongfully denied services in any Model Legislation and as a basis for all advocacy, including those for prior authorization reforms and that CPT codes must fully reflect the aggregated time
