AMA CPT® Assistant - 1997 Issue 12 (December)
1997 Payment Policy Changes Affecting Coding (December 1997)
December 1997 pages 1-4 1997 Payment Policy Changes Affecting Coding On October 31, 1997, the Health Care Financing Administration (HCFA) published in the Federal Register the Final Rule that contained the 1998 Medicare Physician Payment Schedule, the 1998 relative value units, and several payment policy changes. This Federal Register also announced the 1998 conversion factor. For the 1998 Medicare Fee schedule, HCFA is establishing or revising several HCPCS codes to report services that HCFA believes are not clearly described by existing CPT codes. This is planned as a temporary measure until HCFA can refer these codes to the CPT...
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Article Overview
This article summarizes a late-1997 Medicare payment policy update focused on HCFA’s 1998 Final Rule and related coding revisions. It is relevant to coders, billers, compliance staff, and physicians who need a high-level view of how payment policy changes, RVU updates, screening coverage changes, supervision rules, and selected code revisions were being addressed for 1998. The article discusses multiple code families and broader policy topics without serving as a full coding manual.
Why This Topic Matters
The piece helps readers understand which coding areas were being revised under the 1998 Medicare fee schedule and where HCFA was updating coverage, valuation, or usage guidance. It is useful for identifying policy-driven changes that could affect claim reporting and reimbursement planning.
Article Sections
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December 1997 pages 1-4
Introductory material describing the scope of the 1997 payment policy update and the overall Medicare fee schedule context for 1998.
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HCPCS Codes Affected by HCFA Action
Discussion of selected HCPCS code changes announced by HCFA, including temporary coding actions and code revisions tied to Medicare payment policy.
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CPT Codes Affected by HCFA Action
Coverage of selected CPT code changes and clarifications addressed by HCFA, including valuation, reporting, and global period topics.
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PET Myocardial Perfusion Imaging HCPCS Codes Affected by HCFA Action
Review of HCPCS PET myocardial perfusion imaging codes and related HCFA valuation updates within the 1998 payment policy changes.
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Single Conversion Factor
Explanation of the 1998 conversion factor update under the Balanced Budget Act and its role in the revised payment system.
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Other HCFA Policy Changes for 1998
Broader policy updates affecting global surgery, RUC recommendations, practice expense, diagnostic test supervision, and geographic cost indices.
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Global Surgery
Summary of changes related to postoperative work values and surgical payment adjustments under the 1998 final rule.
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RUC Recommendations
Overview of Relative Value Scale Update Committee recommendations and the types of coding revisions associated with those recommendations.
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1998 Practice Expense Adjustment
Discussion of the practice expense adjustment framework and its relationship to payment policy for 1998.
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Diagnostic Tests
Explanation of supervision levels for diagnostic tests and how HCFA described the revised framework for those services.
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GPCI Update
Summary of the geographic cost index update for the 1998-2000 period and its general payment implications.
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Clinical Consultations
Brief notice of a follow-up item related to clinical consultations and standing orders.
What You Will Learn
- Which categories of Medicare payment policy were updated for 1998.
- How HCFA’s Final Rule affected selected HCPCS and CPT topics.
- What broad valuation and coverage areas were addressed in the article.
- Which policy subjects were tied to the Balanced Budget Act and RUC recommendations.
- How the article frames supervision, practice expense, and geographic payment updates.
Who Should Read This
- Medical coders
- Coding educators
- Billing staff
- Compliance teams
- Physicians
- Practice managers
- Reimbursement analysts
Codes Discussed
Code Ranges Discussed
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