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Since surgery isn't getting any easier, why is reimbursement going down? An update from the SGO taskforce on coding and reimbursement.
Uppal, Shitanshu; Shahin, Mark S; Rathbun, Jill A; Goff, Barbara A.
Afiliação
  • Uppal S; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States.
  • Shahin MS; Hanjani Institute for Gynecologic Oncology, Abington Hospital-Jefferson Health, Abington, PA, United States.
  • Rathbun JA; Galileo Consulting Group, Inc, Arlington, VA, United States.
  • Goff BA; Galileo Consulting Group, Inc, Arlington, VA, United States; Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States. Electronic address: bgoff@uw.edu.
Gynecol Oncol ; 144(2): 235-237, 2017 Feb.
Article em En | MEDLINE | ID: mdl-27287507
In 2015, there was an 18% reduction in the Relative Value Units (RVUs) that the Center for Medicare and Medicaid Services (CMS) assigned to the Current Procedural Terminology (CPT) code 58571 (Laparoscopy, surgical, with total hysterectomy, for uterus 250g or less; with removal of tube(s) and/or ovary(s)→TLH+BSO). The other CPT codes for laparoscopic hysterectomy and laparoscopic supracervical hysterectomy (58541-58544 and 58570-58573) lost between 12 and 23% of their assigned RVUs. In 2016, the laparoscopic lymph node dissection codes 38570 (Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple), 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy), and 38572 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), single or multiple) lost between 5.5 and 16.3% of their RVU's. The goals of this article from the Society of Gynecologic Oncology (SGO) Task force on Coding and Reimbursement are 1) to inform the SGO members on why CMS identified these codes as a part of their misvalued services screening program and then finalized a reduction in their payment levels; and 2) outline the role individual providers have in CMS' methodology used to determine the reimbursement of a surgical procedure.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Neoplasias dos Genitais Femininos / Histerectomia / Reembolso de Seguro de Saúde / Excisão de Linfonodo Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: Gynecol Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Neoplasias dos Genitais Femininos / Histerectomia / Reembolso de Seguro de Saúde / Excisão de Linfonodo Limite: Female / Humans País/Região como assunto: America do norte Idioma: En Revista: Gynecol Oncol Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Estados Unidos