Medical billing and coding is undergoing a dramatic shift in the United States right now. After years of using the ICD-9 system, and two annual delays, the nation's healthcare system must now finally adopt the new ICD-10 coding system. Used around the world by most other advanced nations, the US is behind the eight ball in using this more advanced system. As a provider of orthopedic services, what orthopedic coding changes can you expect to see in 2016?
The New Year is upon us, and we know what that means: change. Orthopedic billing changes will be put into effect January 1st with the new, bundled, and removed codes, along with much bigger changes. During this time, it is important to make yourself aware of these changes on the horizon, become educated on them, and learn how your practice can best adapt to them. By doing so, your business is more likely to better maintain both efficiency and profitability throughout these changes.
Medical practices, including radiologists and orthopedic surgeons, are facing numerous challenges in 2015 as the entire healthcare industry debates the benefits of volume-based care versus value-based care. The current volume-based reimbursement model has faced controversy over the idea that doctors may be over-treating patients as a way to generate additional income or in an attempt to keep up with lowered reimbursements. This has created an ethical and financial dilemma for practices who want to be reimbursed at a rate that can keep their doors open, but without over-treating patients or increasing the volume of patients to unmanageable levels. The move from the volume-based to a value-based model is supposed to be a step toward resolving these concerns, but it also raises six critical issues when comparing the two models.Read More
The Centers for Medicare and Medicaid Services (CMS) recently issued a 301 page proposed rule for establishing Stage 3 EHR Meaningful Use (MU) requirements. If you are a practicing physician, including those in the specialties of radiology or orthopedics, the new rule applies to you.Read More
Orthopedic providers may be subject to a reimbursement penalty on all claims submitted to Medicare for 2015. If you are an eligible professional (EP) that participates in the Physician Quality Reporting System (PQRS) or a group practice participating in the Group Practice Reporting Option (GPRO), then you’re in danger of receiving a negative payment adjustment (penalty) of 1.5% on all covered services rendered this year. The 1.5% is to be deducted from the normal Medicare Physician Fee Schedule (MPFS) for services provided. Keep reading to find out if your practice will be affected by the adjustment.Read More