RESUMO
The American Academy of Pediatrics provides this revised policy statement to address health care changes that impact procedural and visit coding and valuation as well as the incorporation of coding principles into innovative, newer payment models. This policy statement focuses solely on recommendations, and an accompanying technical report provides supplemental coding and valuation background.
Assuntos
Codificação Clínica , Current Procedural Terminology , Classificação Internacional de Doenças , Pediatria , Escalas de Valor Relativo , Comitês Consultivos , Centers for Medicare and Medicaid Services, U.S. , Criança , Bases de Dados Factuais , Humanos , Medicaid , Estados UnidosRESUMO
The American Academy of Pediatrics provides this technical report as supplemental background to the accompanying coding and valuation system policy statement. The rapid evolution in health care payment modeling requires that clinicians have a current appreciation of the mechanics of service representation and valuation. The accompanying policy statement provides recommendations relevant to this area, and this technical report provides a format to outline important concepts that allow for effective translation of bedside clinical events into physician payment.
Assuntos
Codificação Clínica , Classificação Internacional de Doenças , Pediatria , Escalas de Valor Relativo , Centers for Medicare and Medicaid Services, U.S. , Codificação Clínica/legislação & jurisprudência , Current Procedural Terminology , Health Insurance Portability and Accountability Act , Humanos , Medicare Access and CHIP Reauthorization Act of 2015 , Estados UnidosRESUMO
The majority of public and private payers in the United States currently use the Medicare Resource-Based Relative Value Scale as the basis for physician payment. Many large group and academic practices have adopted this objective system of physician work to benchmark physician productivity, including using it, wholly or in part, to determine compensation. The Resource-Based Relative Value Scale survey instrument, used to value physician services, was designed primarily for procedural services, leading to current concerns that American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) surveys may undervalue nonprocedural evaluation and management services. The American Academy of Pediatrics is represented on the RUC, the committee charged with maintaining accurate physician work values across specialties and age groups. The Academy, working closely with other primary care and subspecialty societies, actively pursues a balanced RUC membership and a survey instrument that will ensure appropriate work relative value unit assignments, thereby allowing pediatricians to receive appropriate payment for their services relative to other services.
