General Surgery Coding Alert

Bad news: Brace yourself for the possibility of lower Medicare payments -- all physicians, including general surgeons, face a 9.9 percent across-the-board cut for 2008.

Good news: As indicated in the 2008 physician fee schedule proposed rule, released by the CMS and AMA's Medical Association's Relative Value Update Committee (RUC), CMS will adjust the work relative value units (RVUs) for more than 50 procedures. Anesthesiologists will primarily benefit from these adjustments, but big winners also include 19301 (Partial mastectomy) -- which goes up from 6.03 work RVUs to 10 work RVUs -- and a number of proctosigmoidoscopy codes that general surgeons might use.

Great news: Congress may finally be ready to break the cycle of yearly Medicare payment cuts. A June 28 memo from four leading House Democrats to their Democratic colleagues proposes to move forward with ambitious health legislation when Congress returns from its July recess.

This bill would boost payments to rural providers. But it would also end the yearly grind of proposed pay cuts. Not only would the proposed bill get rid of the proposed cut for 2008, but it would also erase 2009's cut as well. And it would "build a glide path to a better payment system for physicians," the memo states. Short-term fixes by previous Congresses have made the plight of physicians worse, the Democratic leaders add.

The House memo doesn't go into detail about how legislative Democrats would fix the physician payment system. But Washington, D.C., sources indicate that Medicare would pay at least a 0.5 percent annual increase in 2008 and 2009.