decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 12 (December)
Final 2017 Medicare physician fee schedule: Expect cuts to excisional bone biopsy, spinal instrumentation codes
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Article Overview
This article reviews major provisions of the final 2017 Medicare physician fee schedule that are relevant to orthopedic and other physician practices. It covers payment updates, revaluations, global period changes, code revisions, modifier and imaging payment policy changes, therapy cap updates, geographic payment adjustments, and Medicare program reminders that may affect reporting and reimbursement compliance. It is useful for physicians, coders, billers, and practice managers who need a high-level view of the year’s Medicare policy changes before reviewing the full guidance.
Why This Topic Matters
The article summarizes several Medicare payment and coding changes that can affect reimbursement, compliance, and work planning for practices that bill physician services. Readers can quickly determine whether the full article contains updates relevant to fee schedule impacts, code valuation, and related Medicare payment rules.
Article Sections
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Fee schedule overview and conversion factor update
Introduces the final 2017 Medicare physician fee schedule and summarizes the overall payment update framework. Covers broad effects on physician reimbursement and the annual conversion factor.
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Procedure-level payment changes
Reviews selected orthopedic and musculoskeletal services that experience valuation or payment changes under the final rule. Also notes code revision activity affecting certain procedure families.
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Review of misvalued zero-day global codes
Describes the CMS process for identifying and narrowing a list of zero-day global services subject to review. Summarizes the types of services included in the final review list.
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Additional final rule changes affecting practices
Covers other Medicare policy updates in the final rule, including statutory adjustment methodology, imaging-related billing changes, payment reductions, phased-in RVU changes, geographic practice cost updates, therapy cap policy, beneficiary billing reminders, and care management supervision rules.
What You Will Learn
- How the final 2017 Medicare physician fee schedule affects overall physician reimbursement
- Which broad categories of orthopedic and imaging services are discussed in the final rule
- How CMS handled review of zero-day global services and other misvalued codes
- What additional Medicare payment and compliance policies were finalized for 2017
Who Should Read This
- Orthopedic surgeons
- Physicians and physician practices
- Medical coders
- Medical billers
- Practice managers
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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