decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 12 (December)
New coding guidance: 2018 fee schedule roundup: Payments, policies and PQRS
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Article Overview
This roundup covers selected 2018 Medicare physician fee schedule final-rule changes that may affect physician practices, anesthesia services, therapy, imaging, pain management, opioid treatment, durable medical equipment, and quality reporting. It is intended for coding professionals, practice managers, and other reimbursement stakeholders who need a high-level view of payment updates, policy adjustments, and reporting changes referenced in CMS materials and related resources.
Why This Topic Matters
The article helps readers identify broad reimbursement and policy changes that could influence practice workflow, expected payment, and reporting obligations for 2018. It is especially relevant for teams tracking CMS final-rule updates across multiple specialties and service categories.
Article Sections
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Fee schedule and anesthesia payment updates
Overview of 2018 physician and anesthesia conversion factor changes, along with related anesthesia valuation updates tied to gastrointestinal endoscopy services.
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Drug and procedure valuation changes
Discussion of selected revisions affecting infusion-related payment language, pain management procedure values, and newly introduced opioid treatment service codes.
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Policy changes
Summary of broader Medicare policy updates affecting low-volume services, pre-service clinical time, vital-signs inputs, monitoring supplies, imaging-related inputs, therapy caps, and patient-relationship reporting elements.
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PQRS and value-based modifier
Overview of quality-reporting requirement changes and the related modifier/penalty adjustments described for 2018.
What You Will Learn
- Which categories of 2018 Medicare payment updates are addressed in the final rule
- How CMS described changes affecting anesthesia, imaging, therapy, and selected procedure valuation areas
- What the article says about low-volume services and specialty assignment resources
- What reporting-related updates are discussed for PQRS and the value-based modifier
Who Should Read This
- Medical coders
- Coding auditors
- Physician practice managers
- Reimbursement specialists
- Anesthesia billing staff
- Quality reporting staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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