ED Coding and Reimbursement Alert
2017 Medicare Fee Schedule Brings Good News for Emergency Physicians
Look for an increase in intubation procedures while ED E/M codes remain stable. The 2017 Medicare physician fee schedule was released on November 2, 2016 with mostly good news for emergency medicine. Check out the ED relevant changes from our expert reviewer. As anticipated, you’ll see minimal changes to the ED E/M codes, critical care, and observation service values in 2017. In fact, CMS predicts that emergency medicine will have a flat impact of zero change, says Michael Granovsky, MD, FACEP, CPC, President of LogixHealth, a national ED coding and billing company based in Bedford, MA. Table 52 of the final rule lists the estimated impact by specialty based on changes to the work, practice expense, and PLI RVUs for 2017. Most of these specialties listed, including Emergency Medicine, had an estimated impact of zero. Winners: There were a few winners such as Anesthesiology, Family Practice, Internal Medicine, and Geriatrics with a 1 percent increase, likely due to changes in the coordination of care codes for the primary care specialties. Losers: The losers in 2017 were Gastroenterology, Interventional Radiology, Pathology with 1 percent decreases, Urology with a 2 percent decrease, and Independent Lab with a 5 percent decrease. Keep in mind rounding can play a big role as to whether you are plus or minus 1 percent or end up with an estimated zero change, adds Granovsky adds. Conversion Factor Increases Based on PAMA Half Percent Update The Medicare Access and CHIP Reauthorization Act mandated a 0.5% increase to the conversion factor for 2017 (see ED Coding Alert May 2015 Vol. 18, No. 5). Several other factors also played a role with small negative adjustments. A negative budget neutrally factor impacted the 2017 conversion factor to offset overall increases in RVUs relative to 2016 as well as a target recapture update of -0.18% related to misvalued codes. The net impact is an increase of about 8 cents to the 2017 conversion factor as shown in Table 50 from the final rule with a published conversion factor of $35.8887, Granovsky says.
ED Coding and Reimbursement Alert
- Medicare Physician Fee Schedule:
2017 Medicare Fee Schedule Brings Good News for Emergency Physicians
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