Accreditation

Surgeons rail against reporting every 10 minutes to CMS

Accreditation Insider, September 13, 2016

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A proposed CMS change to the 2017 Medicare Physician Fee Schedule will require surgeons document and report data every 10 minutes for new billing codes (G-codes). The penalty for not submitting this data is 5% of a facility’s Medicare reimbursement.

CMS’ plans to phase out 10-day and 90-day global surgery packages over the next two years. Instead, the fee schedule would have a zero-day package, with all preoperative and postoperative care bundled together on the day of the surgery. Surgeons would receive a lump sum for their work and bill CMS on a piecemeal basis for care provided before and after the day of surgery.

Surgeons and medical groups have loudly decried the move, calling it impractical, untested, and a huge waste of time and money. In one survey of 7,000 surgeons, 37% said the new codes will cost them between $25,000 and $100,000 per surgeon.  Fifteen percent said it would cost them over $100,000 in hiring scribes to keep up with documentation, updating electronic health records, and having less time for patients.

Respondents also claimed that if the standards go into effect:
•    85.9% will have to modify EHR and billing systems
•    88.8% of physicians and 75.7% of staff will lose time tracking and processing global surgery information into EHR and billing systems
•    82.8% will have to develop new tracking and collecting methods for global surgery data
•    46.4% will need to buy more technology (such as handheld devices or stopwatches) to document time spent providing global surgery services

So far, the American College of Surgeons (ACS), the American Association of Orthopaedic Surgeons, the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS), the American Medical Association, and several others have filed protests with CMS.

"The claims-based data collection mandate is so burdensome that most physicians will not be able to comply by January 1, 2017, which will result in CMS being unable to collect accurate and usable data, particularly in light of the unfinished final rule at the time of this writing," the AANS and CNS wrote in a letter to CMS.
For more, read the full article at HealthLeaders Media.



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