Tag Archive for ‘coding’

Coding and reimbursement for colonoscopy

Coding and reimbursement issues for colonoscopy procedures are the focus of this month’s column.

CMS creates new place of service code for outpatient care at hospitals

This month’s column summarizes the new place of service code and describes the differences between “on” and “off campus” when submitting professional claims.

Changes on the horizon for global services payment

The averted CMS policy that would have transitioned 10- and 90-day global payment codes to 0-day codes is summarized in this article, as is the legislation that will revise global payments in the coming years and the ACS’ advocacy-related role concerning these issues.

2014 fee schedule and CPT code changes will affect surgical practice

Several changes to payment policy and coding and reimbursement will take effect in 2014. Although the Medicare physician fee schedule and coding changes introduce several important payment and coding policies that will affect all physicians, this article focuses on updates particularly relevant to surgery and other related specialties.

ACS releases primer on bundled payment

The ACS recently released the Surgeons and Bundled Payment Models: A Primer for Understanding Alternative Physician Payment Approaches, which summarizes the concept of bundled payment and the effect bundled payment policies could have on surgical practices.

Documentation of services provided in the postoperative global period

Over the last year, the U.S. Department of Health and Human Services (HHS) has gradually increased its analysis of the value of global surgical packages. In particular, HHS has focused on the evaluation and management (E/M) services provided within the postoperative period, which are included in the value of the global surgical package. This column offers suggestions on how ACS Fellows may document services provided during the global period and explains why HHS is interested in the measurement of postoperative work.

2013 payment policy and coding changes affecting surgical practice

Several changes to payment policy and coding and reimbursement will take effect in 2013. Although the Medicare physician fee schedule and coding changes introduce several important payment and coding policies that will affect all physicians, this article focuses on updates particularly relevant to surgery and other related specialties.

Table 1: Incentives and penalties under the eRx program

Participating in the Medicare eRx Incentive Program

The Centers for Medicare & Medicaid Services (CMS) Electronic Prescribing, or eRx, Incentive Program was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). CMS defines e-prescribing as “the ability to electronically send an accurate, error-free, and understandable prescription directly to a pharmacy from the point-of-care.” Eligible professionals (EPs) who successfully […]

Table 1. New skin replacement surgery codes 2012

Coding for skin replacement surgery in 2012

In 2012, comprehensive changes were made to the skin substitute codes, including the addition of new introductory language and the creation of eight new Current Procedural Terminology (CPT) codes that describe topical application of skin substitute grafts

CPT 2012 brings with it new codes and code changes

The Current Procedural Terminology (CPT)* 2012 manual comprises several new codes and code changes pertaining to general surgery and its closely related specialties. This article summarizes these modifications. New modifier The Affordable Care Act (ACA) requires all health care plans to begin covering immunizations and preventive services without any cost sharing. Modifier 33 has been […]

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