decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 4 (April)
Comprehensive joint replacement model: Telehealth and home visits could help CJR practices cut costs on joint replacements
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Article Overview
This article is for orthopedic practices, hospitals, coders, and billers involved in Medicare’s Comprehensive Care for Joint Replacement model. It summarizes the bundled-payment context, the post-discharge home-visit and telehealth options available under the model, and the CMS policy sources and billing-related updates that affect CJR participants.
Why This Topic Matters
CJR participation changes how practices manage post-operative follow-up and report certain services, so understanding the model’s payment structure and associated billing guidance is important for cost management, compliance, and care coordination.
Article Sections
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CJR model overview
Introduces the mandatory bundled-payment model and its general purpose for joint replacement episodes. Discusses the practices and facilities affected by the program.
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Home care is a cheaper alternative
Covers post-discharge care coordination themes and the home-visit billing approach tied to the model. Also references CMS policy guidance and related payment considerations.
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Use telehealth to keep tabs on CJR patients
Summarizes the telehealth component of the model and the related Medicare coverage and documentation framework. Notes the CMS manuals and guidance sources that support the policy.
What You Will Learn
- How the CJR model affects joint replacement episodes of care
- What general categories of post-discharge services are addressed in the article
- Which CMS policy sources are cited for CJR-related billing guidance
- What kinds of Medicare telehealth and home-visit topics are discussed for CJR participants
Who Should Read This
- Orthopedic practices
- Hospitals
- Medical coders
- Medical billers
- Practice administrators
- Care coordination staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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