decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 12 (December)
Medicare keeps RVUs in 2007 for 3 key ortho surgery codes
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Article Overview
This article reviews 2007 Medicare physician fee schedule updates relevant to orthopedics, including RVU changes, conversion factor updates, OPPS imaging caps, and select code-by-code fee impacts. It is useful for orthopedic practices, physician coders, and billing staff who need to understand which services saw fee increases or decreases and how CMS policy changes affected high-volume orthopedic services.
Why This Topic Matters
Orthopedic groups rely on Medicare fee updates to anticipate revenue changes, monitor high-volume services, and plan for the impact of RVU and imaging-payment policy changes. The article helps readers identify which broad service categories were affected in 2007 and which specialty organizations were involved in advocating on behalf of the affected codes.
Article Sections
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Medicare fee schedule overview
Summarizes the 2007 Medicare physician fee schedule context, including conversion factor changes and overall specialty-wide payment effects. It also introduces the orthopedic services most affected by the update.
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Key orthopedic surgery RVU decision
Discusses the CMS decision on maintaining current work values for three major orthopedic surgery services and the advocacy response from specialty organizations. The section explains the broader significance of the RVU action for orthopedics.
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Selected fee changes and policy updates
Covers additional Medicare fee schedule developments affecting orthopedic practice, including changes tied to implants, radiology, spinal injections, supplies, E/M services, and imaging payment policies. It also notes broader payment methodology updates referenced by CMS.
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New ortho code fees
Presents a table of newly referenced orthopedic procedure codes and their projected Medicare fee values for 2007. This section is a code-focused fee summary for newly listed services.
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OPPS-capped orthopedic codes
Lists imaging-related orthopedic codes affected by the outpatient payment cap and compares physician fee schedule amounts with hospital outpatient rates. The section highlights technical component billing impacts and usage context.
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2007 orthopedic code winners & losers
Provides a comparative summary of high-volume orthopedic codes that increased or decreased in Medicare payment for 2007. It is organized as a broad winners-and-losers fee overview.
What You Will Learn
- How the 2007 Medicare physician fee schedule affected orthopedic services
- Which categories of orthopedic codes were discussed in relation to RVU and fee changes
- How CMS policy updates influenced imaging, office visit, injection, and supply payment areas
- Which specialty organizations were involved in commenting on the orthopedic RVU issue
- How the article organizes orthopedic codes into new codes, OPPS-capped codes, and payment winners and losers
Who Should Read This
- Orthopedic practices
- Medical coders
- Billing specialists
- Practice managers
- Revenue cycle staff
- Physician reimbursement analysts
Codes Discussed
Modifiers Discussed
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