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Final 2015 Medicare physician fee schedule rule released, no more global periods....

  1. #1
    Default Final 2015 Medicare physician fee schedule rule released, no more global periods....
    Medical Coding Books
    Well I have spent the last 45 minutes reading the portion related to global periods and how they are going to phase them out starting with 10 day global periods in 2017 and 90 in 2018.

    It appears that we are going to have to start submitting regular E/M codes for each post-op visit when they do this. They are going to have to meet the same guideline requirements as all other E/M services as it does not appear they are going to create a new code or codes to represent these services.

    I must admit to be caught off guard by this one. Their logic makes sense, I'm just worried about the fall out and thought I would share.

    https://s3.amazonaws.com/public-insp...2014-26183.pdf

    Laura, CPC, CPMA, CPC-I, CEMC

  2. #2
    Location
    Columbia, MO
    Posts
    12,913
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    You know this probably will mean the reimbursement for every surgery will be decreased, this could be good or very bad!

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Baton Rouge
    Posts
    1,241
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    I'd read a little something about this a couple months ago...glad to see there's something more official to refer to now

    BUT WOWWWW that's a big document!!!!
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  4. #4
    Location
    New Windsor, New York
    Posts
    1,183
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    I too read a short article about this earlier, now have something official. Gee, the official release of the fee schedule is a big document? Shocking!

    As for whether this will be good or bad - I think it will be good, as it will be more accurately reflect the work actually done by the physician because all follow-up visits will now be tracked. No "gaming" where another diagnosis is used and -24 is added (yes, I have seen that - and my concerns get ignored - one of the lessons I learned that got me interested in compliance!) If Debra's concern about reimbursement being decreased for some procedures is correct, hopefully that can at least be somewhat offset by now being able to charge for aftercare.

    Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC

    Director, Health Information Management
    HealthAlliance of the Hudson Valley
    Kingston, NY

  5. Default Agree
    I agree that it should be good and is appropriate. It always seemed insane that for example discharge day management was part of the global. But I guess it remains to be seen how all this will work with the various payers. There is always a period of confusion!
    And I guess some of modifiers might not be necessary at some point. But don't want to assume.

    Jim

  6. #6
    Location
    Monroe, NC
    Posts
    47
    Default
    My concern is for the patients who won't get aftercare since they won't be able to afford the high office visit copays. I suspect infection rates will increase and hospitalizations will as well. People just won't go when they can't afford it. There will be at home suture removals etc. I don't think it is reasonable and is detrimental to the patients. By the way reporting of post op visits has always been possible, just could not charge.

    Can you imagine new mothers with post partum depression who won't get help because they can't afford to go back?

    Very sad.

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