decisionhealth Newsletters, Coder Pink Sheets - 2012 Issue 8 (August)
2013 fee schedule: Revalued post-operative RVUs could trim pay for orthopedic surgeries
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Article Overview
This article explains a Medicare fee schedule proposal from CMS that would reassess how post-operative work is valued within global surgical packages. It is aimed at orthopedic and other surgical practices, as well as coders and compliance professionals, who need to understand the policy context, payment implications, and comment opportunity related to the 2013 proposed rule.
Why This Topic Matters
The proposal could alter how post-operative E/M work is valued and may affect reimbursement patterns and patient follow-up expectations across surgical specialties, including orthopedics.
Article Sections
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Overview of the proposed fee schedule change
Introduces the CMS proposal and its focus on post-operative work within global surgical packages. Summarizes the general payment concerns raised for surgeons and orthopedic practices.
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Why CMS is reviewing post-operative RVUs
Explains the agency’s concern that current valuation methods may not reflect actual post-operative work. Discusses the broader issue of variation in E/M RVUs across procedures.
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Practice and policy implications
Describes how the proposal could affect surgical reimbursement and follow-up care patterns. Notes related payment adjustments and the opportunity for public comment on the rule.
What You Will Learn
- The policy context behind CMS’ review of post-operative work in global surgical packages
- Why surgeons and orthopedic practices may be affected by the proposed valuation changes
- How the proposal fits into broader Medicare physician fee schedule updates and related payment issues
- Where the rulemaking process stands and how stakeholders can respond
Who Should Read This
- Orthopedic coders
- Surgical coders
- Compliance professionals
- Physician practice managers
- Medical billers
- Health policy readers
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