October 2016
Welcome to October issue of the ATS Coding and Billing Quarterly.
The physician community is waiting on a number of important final rules from CMS that will significantly impact medicine in 2017 and beyond. Just before this issue went to press, CMS released the final rule on MACRA (Medicare Access and CHIP Authorization Act) – a small acronym that will usher in large changes in the U.S health system. As we reported in the June issue of the ATS Coding and Billing Quarterly, MACRA will bring significant short and long term changes to the physician community by requiring most physicians who participate in the Medicare program to participate in either Advanced Alternative Payment Models (APMs – essentially risk sharing payment arrangements) or participate in MIPS (Merit-based Improvement System – a combined system that include quality measures, practice improvement activities and certified EHR use). Since the final rule was only just released, this issue provides only a cursory overview of the final MACRA rule. The January 2017 issue of the ATS Coding and Billing Quarterly will provide a more comprehensive review of the MACRA rule.
We are also awaiting publication of the final Medicare Physician Fee Schedule which will provide important guidance on payment rates, new procedure codes and changes to quality measures. Please see our January issue for a full detailing of both these pending rules.
In the meantime, this issue will provide you with updates on ATS efforts to improve the ICD-10-CM nomenclature for pulmonary hypertension. It also notes changes in G codes for reporting smoking cessation counseling, revisions to COPD/bronchodilator use quality measures and addresses the continued confusion on appropriate coding for EBUS procedures.
As always, we welcome your suggestions for future articles and any coding, billing or regulatory compliance issues you may have.
Sincerely,
Alan L. Plummer, MD
Editor
