decisionhealth Newsletters, Part B News - 2001 Issue 3 (March)
Specialty doctors fight for post-operative pay
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Article Overview
This article examines a payment and valuation dispute involving specialty societies, the AMA RUC, and HCFA/Medicare policy. It focuses on how post-operative critical care is being discussed in relation to work RVUs, the 90-day global period, and whether certain services should be treated as part of surgical payments or separately valued physician work. The discussion is relevant to physicians, coders, compliance staff, and reimbursement professionals following specialty payment policy.
Why This Topic Matters
The piece highlights how coding, valuation, and global-period payment policy can affect reimbursement for post-operative care and how specialty societies influence those decisions. It also shows how RUC recommendations and agency review can shape future physician fee schedule changes.
What You Will Learn
- The general nature of the reimbursement dispute involving post-operative critical care
- How specialty societies and the RUC factor into physician payment valuation
- Why Medicare global-period policy is central to the debate
- What kinds of stakeholders are involved in the disagreement over post-surgical care payment
Who Should Read This
- Physician coders
- Reimbursement professionals
- Compliance staff
- Physicians involved in specialty society payment issues
- Health policy analysts
Codes Discussed
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