Spineline - November/December 2017

42 SPINELINE | NOVEMBER · DECEMBER 2017 WWW.SPINELINE-DIGITAL.ORG Allison Waxler, MS

Director of Regulatory Affairs North American Spine Society Washington, DC

2018 Medicare Physician Fee
Schedule

The Centers for Medicare and Medicaid Services (CMS) released the 2018 Medicare final rules for the Medicare Physician Fee Schedule as well as for payments for services provided in hospital outpatient departments and ambulatory surgical centers (ASCs). Both rules will be implemented January 1, 2018.

Medicare Physician Fee Schedule

The 2018 conversion factor will be $35.9996, a slight increase from the 2017 factor of $35.89.

Preservice Clinical Labor for 0- and 10-
Day Global Periods

CMS solicited input on assigning a standard time of zero minutes for preservice clinical labor for all CPT codes with 0- and 10-day global periods as they are considered to be minor procedures not requiring clinical staff time. Based on feedback from NASS and other stakeholders, CMS is not finalizing this proposal and indicated they will continue to look at preservice clinical labor on an individual code basis. CMS also noted that they will look for ways to standardize clinical labor inputs based on the type of procedures with 0- and 10-day global periods.

Potentially Misvalued Services

In the proposed rule, CMS identified code 27279 for percutaneous or minimally invasive sacroiliac joint fusion as potentially misvalued. Because it is a new code, it is already scheduled for review by the AMA Relative Value Update Committee (RUC) in October 2018. In comments on the proposed rule, NASS supported following the standard review process.

In the final rule, CMS agreed the code is misvalued and request review by the RUC either in October 2018 as initially scheduled or on an expedited timeline that would allow for inclusion in the 2019 fee schedule proposed rule.

Appropriate Use Criteria for Advanced
Diagnostic Imaging

CMS is finalizing a start date of January 1, 2020, a one-year delay from the proposal, for the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. This delay will allow practitioners more time to focus on and adjust to the Quality Payment Program before being required to participate in the AUC program. The Medicare AUC program will begin with an educational and operations testing year in 2020, meaning physicians would be required to start using AUCs and reporting