News

On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates final rule. Please note that physician payment is made under the Physician Fee Schedule; hospitals are paid for outpatient services under the OPPS and ASCs are paid under the ASC payment system, both detailed in this rulemaking. The ASC Payment Indicator for 63 CPT codes changed from J8 to G2 from the 2018 proposed rule to the 2018 final rule. ASC procedures assigned to J8 are designated as device-intensive, meaning the device cost exceeds 40 percent of the procedure’s mean cost. Device-intensive procedures are priced […]

Code changes for all medical specialties take effect on January 1, 2018 as a result of the CPT Editorial Panel process. The American Medical Association (AMA) is responsible for Current Procedural Terminology (CPT) and has convened the CPT Editorial Panel to develop and maintain the nomenclature healthcare providers use to report medical procedures and services. The CPT Editorial Panel meets three times a year to evaluate code change proposals for new and emerging technology and is responsible for reorganizing and maintaining the code set. After codes are created or modified by the CPT Editorial Panel, they go before the Relative Value Update Committee (RUC), also convened by the AMA, to be valued. For more information on the RUC process and […]

Wishing you a very happy and healthy 2018!   News and noteworthy information for December 2017: What’s New in Spine Coding for 2018? Quality Payment Program – Act NOW to Avoid Losing 4% of your Medicare Reimbursements FDA Proposes Updates to Medical Device Approval Process in 2018   What’s New in Spine Coding for 2018? Code changes for all medical specialties take effect on January 1, 2018 as a result of the CPT Editorial Panel process. The American Medical Association (AMA) is responsible for Current Procedural Terminology (CPT) and has convened the CPT Editorial Panel to develop and maintain the nomenclature healthcare providers use to report medical procedures and services. The CPT Editorial Panel meets three times a year to […]

On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released a final rule to continue implementation of the Quality Payment Program (QPP) required by the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). MACRA was bipartisan legislation signed into law in the spring of 2015 to permanently repeal the Sustainable Growth Rate (SGR), streamline quality reporting programs, and provide incentive payments for participation in advanced alternative payment models. After an initial rulemaking last year, the QPP went into effect January 1, 2017. Based on feedback from stakeholders over the last several months, CMS has finalized some changes to the QPP and its two tracks for Medicare payment in 2018 and beyond: Merit-Based Incentive Payment System (MIPS) […]