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Developing Codes to Capture Post-Operative Care

出版	RAND, 2016
ISBN	08330954129780833095411
URL	http://books.google.com.hk/books?id=SD9oAQAACAAJ&hl=&source=gbs_api

註釋"The Centers for Medicare & Medicaid Services (CMS) uses a fee schedule to pay physicians and nonphysician practitioners for their professional services. For many surgeries and other types of procedures, Medicare's payment for the procedure includes post-operative visits delivered during a global period of ten or 90 days anchored on the surgery date. The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS gather the necessary data to appropriately value post-operative care. The law requires CMS to collect data on the "number and level" of visits in the global period from a representative sample of physicians beginning January 1, 2017. Congress suggested, but does not require, that the data be collected through claims. CMS asked the RAND Corporation to provide recommendations on how to best collect the number and level of post-operative visits through the use of nonpayment claims. To do so, RAND first gathered input from individuals performing surgical procedures on the range of post-operative care provided during the global period. RAND consulted with an expert panel on how to categorize the care into codes that capture the major differences in the breadth and intensity of post-operative care across care settings. This report provides recommendations for a set of nonpayment codes that combine visit times with the complexity of services, for both inpatient and office-based services. The recommended codes attempt to balance the need for a simple and straightforward system with the demand for a set of codes to capture the granularity and heterogeneity associated with post-operative care delivery"--Description del’éditeur.