| 2020 Coding Policy Updates Include Shoulder Revision
The Centers for Medicare and Medicaid Services (CMS) recently released the National Correct Coding Initiative (NCCI) Policy Manual for Medicare Services for 2020. Specifically, the Arthroscopy section within Musculoskeletal System (Chapter IV) has been revised regarding the shoulder. Previous policy stated that CMS considers the shoulder to be a single anatomic structure. For 2020, this line has been deleted from the manual. While code pair edits remain for some shoulder arthroscopy procedures (eg, 29827, 29828) with limited debridement (eg, 29822), the AAOS applauds this change which it has advocated for since 2010 in conjunction with the following groups: the American Shoulder and Elbow Surgeons, the Arthroscopy Association of North America—both members of the Orthopaedic PAC Advisor’s Circle—and the American Orthopaedic Society for Sports Medicine. Access the NCCI policy manual…
CMS Requests Feedback on Scope of Practice
On December 26, the Centers for Medicare and Medicaid Services (CMS) announced that it is seeking input and recommendations for easing scope of practice restrictions. The request comes in response to the President’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, which directs the agency to propose reforms for eliminating certain supervision and licensure requirements that “limit healthcare professionals from practicing at the top of their professional license.” However, organizations including the AAOS are warning CMS that broadening scope of practice for non-physician providers will jeopardize patient care. They point to nurse practitioners and physician assistants who have less training and expertise. AAOS continues to advocate this long-standing position and will submit formal commits to CMS before the January 17 deadline. Read CMS’ request for feedback…
Testing Period Begins for New AUC Program
The Educational and Operations Testing Period for a new appropriate use criteria (AUC) program officially began on January 1. During this time, physicians who order and refer patients for imaging tests may by contacted by radiology labs with the message that the Protecting Access to Medicare Act “requires” them to consult AUC prior to ordering advanced diagnostic imaging services. The Centers for Medicare and Medicaid Services, however, has clarified that in 2020 it “expects” ordering professionals to begin consulting qualified Clinical Decision Support Mechanisms and providing information to the furnishing practitioners and providers for reporting on their claims. Importantly, there will be no payment consequences associated with the program and claims will NOT be denied for failing to include AUC-related information or for misreporting AUC information on non-imaging claims. Further questions may be submitted via imagingAUC@cms.hhs.gov. Read more about the new AUC program…
LAST CALL: Applications Due Tomorrow for Frankle Health Care Policy Award
The American Shoulder and Elbow Surgeons (ASES), in partnership with the AAOS Orthopaedic Political Action Committee, is seeking applications for the Mark Frankle, MD, Health Care Policy Award, which provides selected ASES fellows unprecedented involvement in federal and state legislative policy. Each applicant must be an ASES resident fellow or candidate/associate member. Winners will receive a fellowship at the AAOS Office of Government Relations in Washington, D.C.; $12,500 for fellowship expenses; an opportunity to present findings at the ASES Annual Meeting in October 2020 in New York City; and exposure to health policy through Capitol Hill visits, and events such as the AAOS National Orthopaedic Conference and AAOS Board of Specialty Societies and Board of Councilors session. The deadline to submit an application is Jan. 15, 2020. Apply for the health care policy award… |
