decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 9 (September)
Proposed physician fee schedule: CMS may overhaul E/M coding; history (and exam) may be history
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Article Overview
This article reviews major elements of CMS’s 2018 proposed Medicare physician fee schedule, with emphasis on possible evaluation and management documentation reforms and other payment-policy changes. It is aimed at physicians, coders, billing professionals, and practice administrators who need to understand proposed Medicare updates affecting documentation, reimbursement, imaging, and selected specialty services. The piece also summarizes broader fee schedule proposals, including new services, code reviews, imaging program timing, and accountable care organization-related adjustments.
Why This Topic Matters
The proposal could affect how providers document visits, how services are valued, and how Medicare payment policy evolves across multiple specialties and settings. Understanding the scope of the rule helps practices assess operational impact and prepare comments or workflow changes.
Article Sections
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CMS proposes reform of E/M documentation guidelines
Discusses CMS’s request for comment on potential changes to evaluation and management documentation policy and the broader direction of the proposed reform effort.
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Other notable provisions in the proposed fee schedule
Summarizes additional proposed Medicare physician fee schedule items, including conversion factor updates, new services, code reviews, imaging program timing, and shared services changes.
What You Will Learn
- What CMS is proposing in the 2018 Medicare physician fee schedule
- Which broad documentation areas CMS is reconsidering for evaluation and management services
- What types of payment and valuation changes are included in the proposal
- How the rule touches multiple specialties and Medicare program areas
- What stakeholders may want to monitor or comment on in the proposed rule
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice administrators
- Compliance professionals
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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