decisionhealth Newsletters, Coder Pink Sheets - 2016 Issue 8 (August)
Proposed fee and code changes: CMS targets prolonged services, epidural injections and more with RVU changes
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Article Overview
This article reviews CMS’s proposed 2017 Medicare physician fee schedule updates for relative value units tied to revised, deleted, converted, and newly created CPT services. It is relevant to coding and reimbursement professionals who need to track valuation changes, code crosswalks, and the restructuring of services in areas such as surgery, therapy, spine, and injections.
Why This Topic Matters
The proposals affect how multiple services are classified, valued, and reported under Medicare. Readers working in coding, billing, compliance, and revenue cycle management can use the article to understand which service areas are changing and which code families are being reorganized for the next fee schedule year.
Article Sections
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Proposed RVU revisions to existing codes
This section outlines CMS’s proposed valuation changes for selected established CPT services across several specialties. It focuses on broad fee schedule adjustments for revised or reviewed codes.
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New codes in proposed 2017 fee schedule
This section summarizes newly proposed CPT code groupings and converted services in the 2017 fee schedule. It covers broad changes affecting spine procedures, therapy evaluations, fracture treatment, and injection services.
What You Will Learn
- How CMS is proposing to revise RVUs for selected existing CPT services
- Which broad service categories are receiving new or restructured CPT codes
- How the proposed fee schedule addresses code deletions, replacements, and conversions
- What types of specialties and procedure families are affected by the proposed changes
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Physician practices
- Therapy providers
- Reimbursement analysts
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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