decisionhealth Newsletters, Part B News - 2019 Issue 11 (November)
Drug device implants get sliced, sacroiliac fusion, X-ray codes get a raise
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Article Overview
This article reviews selected 2020 Medicare physician fee schedule changes affecting procedure valuation across multiple specialties. It explains how CMS and the AMA RUC addressed updated work RVUs, reimbursement shifts, and coverage status for a set of CPT services, including surgical, orthopedic, pain management, hand, and radiology procedures. The piece is useful for coders, billers, and practice leaders tracking annual fee schedule revisions and their impact on Medicare payment.
Why This Topic Matters
The article helps readers identify which commonly reported CPT services were revalued, reduced, increased, or deemed non-covered in the 2020 Medicare physician fee schedule. That makes it relevant for fee schedule review, budgeting, and compliance awareness across affected practices.
Article Sections
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Overview of 2020 Medicare physician fee schedule changes
Introduces the scope of the fee schedule update and the types of services affected across different clinical areas.
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Drug device implant and removal valuations
Summarizes Medicare valuation changes for implant-related procedures and related reimbursement impacts.
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Manual preparation and insertion of drug-delivery device codes
Covers CMS and RUC valuation decisions for a related group of add-on procedures and their reporting context.
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Dry needling coverage status
Discusses Medicare coverage status for new trigger point dry needling procedures and related policy context.
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Hand tendon sheath procedure valuations
Reviews revised values for selected hand and tendon sheath procedures and the reasons they were reexamined.
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Closed acetabular fracture treatment
Summarizes the reimbursement change for a closed fracture treatment service in the 2020 fee schedule.
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Sacroiliac joint fusion
Describes the valuation update for sacroiliac joint fusion and the resulting payment impact.
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X-ray surgical specimen imaging
Covers the revaluation of a radiology service and the broader discussion of concurrent service valuation.
What You Will Learn
- Which categories of CPT services were revalued in the 2020 Medicare physician fee schedule
- How CMS and the AMA RUC influenced valuation updates for selected procedures
- Which services experienced payment increases, decreases, or non-coverage status changes
- How annual fee schedule updates can affect multiple specialties and practice settings
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Physician office administrators
- Compliance teams
- Orthopedic and surgical specialty practices
- Radiology practices
Codes Discussed
Code Ranges Discussed
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