Topics:
coding edits, fee schedules, feedback, medicare, medicare access and chip reauthorization act, patient protection and affordable care act, practice management, relative value scales, medicare payment advisory commission, united states dept. of health and human services

After a lengthy period of stability, this year brought with it some significant and substantial changes to anesthesia billing and coding. In its proposed rule for the 2016 Medicare Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) identified two long-standing codes that described anesthesia for upper and lower GI endoscopy as “potentially misvalued”. Since that time, ASA worked with CMS and through the CPT® and AMA/Specialty Society Relative Value Scale Update Committee (RUC) processes to advocate for an accurate valuation of these anesthesia services. That work culminated with the deletion of the two codes that were identified as potentially misvalued and the creation of a series of five new codes that more specifically describe these anesthesia services. The increased specificity is accompanied by variation in the base unit values assigned to these services (see Table 1). We also saw changes to the values assigned to...

You do not currently have access to this content.