tci Medicare Compliance & Reimbursement - 2012 Issue 11
Global Surgery Package Pay for Cardiovascular, Musculoskeletal Surgeons Could Be Slashed
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Article Overview
This article reviews two Office of Inspector General (OIG) audit reports focused on global surgery payment for cardiovascular and musculoskeletal specialties. It explains why the findings matter to surgeons, coders, compliance staff, and Medicare stakeholders by showing how audit results can influence CMS policy and global package payment methodology. The piece provides a high-level summary of the audit findings, the payment implications, and the broader issue of bundled E/M services in global surgical fees.
Why This Topic Matters
Global surgery payment methodology affects reimbursement accuracy, compliance risk, and how bundled evaluation and management services are accounted for in Medicare payments. Audit findings like these can prompt policy changes that materially affect revenue for affected surgical specialties and the way global packages are evaluated.
What You Will Learn
- How OIG audits can assess whether global surgical packages align with services actually performed
- Why bundled evaluation and management services are a focus in global surgery payment reviews
- How audit findings may influence CMS payment adjustments for surgical specialties
- What the reported payment impact is for the affected cardiovascular and musculoskeletal groups
Who Should Read This
- Medical coders
- Compliance professionals
- Billing staff
- Physicians in surgical specialties
- Revenue cycle professionals
- Healthcare administrators
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