decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 10 (October)
Getting paid: Docs are not fond of proposed global period G codes — here’s why
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Article Overview
This article explains a CMS proposal discussed in connection with the physician fee schedule and MACRA-related data collection for surgical global periods. It summarizes objections from physician groups and specialty societies, the operational concerns they raised, and the alternative reporting approach they preferred. The piece is relevant to physicians, surgeons, coding and billing professionals, compliance teams, and anyone tracking Medicare payment policy and surgical global period reporting.
Why This Topic Matters
The proposal affects how surgical services and postoperative follow-up activity may be documented and collected for Medicare payment policy purposes. Understanding the debate helps readers follow potential administrative and workflow impacts and the broader policy direction for valuing surgical procedures.
Article Sections
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CMS proposal and physician reaction
Introduces the CMS fee schedule proposal and summarizes the immediate concerns raised by physicians about reporting requirements tied to surgical global periods.
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Definition of representative sample up for debate
Discusses the statutory background, the meaning of representative sampling, and the scope of the data collection effort as described by CMS and physician representatives.
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Doctors prefer 99024
Describes the alternative reporting approach favored by physicians and the operational concerns they raised about existing system support and claim submission workflows.
What You Will Learn
- The policy context behind CMS data collection efforts related to surgical global periods
- Why physician groups objected to the proposed reporting approach
- How specialty societies and CMS discussed sampling scope and administrative burden
- What alternative existing reporting mechanism physicians preferred to discuss
Who Should Read This
- Physicians
- Surgeons
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Health policy analysts
Codes Discussed
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