Just a tidbit of information for 2012....
Knee Menisectomy Medicare payments changed in 2012 Medicare Physician Fee Schedule
On Tuesday, November 01, 2011 the Centers for Medicare and Medicaid Services (CMS) released the 2012 Medicare Physician Fee Schedule final rule.
In addition to covering rules and regulations set for implementation in calendar year 2012, the rule includes the final physician fee schedule with a distinct Relative Value Unit (RVU) for every procedure with a code in the fee schedule. Every year there are changes made to the RVUs for procedures, including orthopaedic procedures, within the fee schedule. The extent of these changes range from year to year. This year, two common orthopaedic procedures two arthroscopic menisectomy repair codes, CPT code 29880-Arthroscopic Menisectomy Medial and Lateral, and CPT code 29881, Arthroscopic Menisectomy Medial or Lateral were altered.
Specifically the total RVUs for CPT code 29880 have changed from 20.14 to 16.85 a decrease of 16% percent. The total RVUs for CPT code 29881 have changed from 18.82 to 16.16, a decrease of 14% percent. In addition, the actual CPT descriptors for each of these codes have been changed to include chondroplasty when performed at the same time.
Thus, Physicians should no longer report the G2089 (for Medicare only) or CPT code 29877 at the same as 29880 or 29881. To be clear, these changes were not brought by the AAOS, but rather by CMS themselves as part of their periodic review of the values of established procedures. The AAOS was asked to conduct member surveys on the amount of time and intensity required to deliver these services. The results of the survey would then be used to calculate relative work RVUs. The AAOS, in collaboration with the Arthroscopy Association of North America (AANA) and the American Association of Hip & Knee Surgeons (AAHKS) surveyed the procedures as requested and the results for the typical time required to perform the procedures were much, much lower than what the previous RVUs had been based on (for 29880, the “skin-to-skin” time went from 66 minutes to 40 minutes, a 44% decrease; for 29881, the “skin-to-skin” time went from 66 minutes to 40 minutes, a decrease of 39%). These changes will be of significant impact for many surgeons; however, the fact that the total RVUs decreased 16% and 14% respectively while the “skin-to-skin” times deceased by 44% and 39% means these procedures retained a significant amount of the previous value.
In addition the Arthroscopic Knee Menisectomy procedures, there were more than two dozen other procedures reevaluated by CMS in a similar process but none with as much impact. A full summary of changes as well as a summary of other parts of the 2012 Medicare Physician Fee Schedule final rule will be posted in future Advocacy Now Updates as well as on the AAOS website at
www.aaos.org. Please check for updates on this and other regulatory actions as well as a report on new and revised CPT codes for 2012 which will require changes in how physicians report and code certain procedures.
http://www.aaos.org/govern/public/Medicare/PFSCHANGE.asp
