CMS proposes new joint replacement bundled payment program
CMS proposed a new bundled payment program for joint replacement surgeries on July 9 and most hospitals will be required to participate. As important members of joint replacement surgery teams, anesthesiologists are affected by this proposed program as well, according to an Anesthesia Business Consultants blog post.
6 things anesthesiologists need to know:
- The proposed rule for the Comprehensive Care for Joint Replacement program requires nearly all affected hospitals to be financially responsible for the care of patients for 90 days after discharge.
- Physicians are not subject to the rule, but the success of the program will depend on their participation.
- Additionally, hospitals may share CCJR savings or penalties with physicians by agreement.
- Participating hospitals would be eligible for bonus payments in 2017 for performance in 2016. They would also see decreased payments; however this will only begin in the following cycle.
- Hospitals would also be expected to meet certain quality measures, including “Hospital-Level 30-day, All-Cause Risk-Standardized Readmission Rate Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty.”
- CMS will consider public comments received on the proposed rule through Sept. 8
Complete List of Valid ICD10 Codes
CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD- 10-CM and GEMs web page. The file is named icd10cm_codes_2016.txt. This file will be useful for physician offices and other providers who want to check to make sure that they are reporting all characters in a valid ICD-10-CM code. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure if additional characters are needed, such as the addition of a 7th character in order to arrive at a valid code.
