Outpatient Facility Coding Alert - 2018 Issue 2
News You Can Use: Increase in Conversion Factor Will Boost Your 2018 Bottom Line
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Article Overview
This article reviews a 2018 Medicare fee schedule update and its broader implications for physician reimbursement. It discusses CMS commentary on evaluation and management documentation, emergency department valuation concerns, and chronic care management guidance, along with the revised conversion factor used in payment calculations. The piece is aimed at coders, billers, and reimbursement professionals who need to track policy updates that may affect office, emergency department, and care management revenue.
Why This Topic Matters
The article explains policy changes and pending guidance that can affect Medicare payment levels and documentation expectations across multiple service categories. It is relevant to organizations monitoring reimbursement updates, especially those coding evaluation and management services and chronic care management.
Article Sections
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Revenue impact of the 2018 fee schedule
Overview of the Medicare update that affected reimbursement calculations for the year and the general payment context discussed in the article.
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Emergency department valuation concerns
Discussion of CMS comments about relative value concerns for emergency department services and the status of future review considerations.
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E/M guidelines may see updates
Summary of the article’s discussion of possible broader changes to evaluation and management documentation guidance and the multi-year nature of the issue.
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Chronic care management
Coverage of CMS discussion about potential changes to chronic care management guidance and practitioner billing concerns.
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Note new conversion factor
Presentation of the updated Medicare conversion factor and its role in payment calculation examples.
What You Will Learn
- How the 2018 Medicare fee schedule update affected the conversion factor
- What CMS said about evaluation and management documentation guidance
- Why emergency department valuation remained a topic of discussion
- How chronic care management guidance was being reconsidered
- How the conversion factor fits into Medicare payment calculations
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance staff
- Emergency department billing professionals
- Physician practice managers
Codes Discussed
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