medicare reimbursement benchmark definition

Medicare reimbursement benchmark definition code#

Medicare’s unpopular time-only definition for the substantive portion of a split/shared visit will remain on hold for another year if Medicare holds to its proposal.

Temporary substantive portion definition for split/shared visits gets another year.

Two new codes for percutaneous insertion or replacement of peripheral nerve electrode arrays with integrated neurostimulators and imaging guidance.

Two new CPT Category I codes for endoscopic nasal nerve destruction.

Phrenic nerve stimulation is a treatment for sleep apnea.

Eight new CPT Category I codes for phrenic nerve stimulation system devices will replace 13 Category III codes.

New codes for placement and removal of vertebral body tethering, an alternative to rigid instrumentation for young patients with congenital spine deformities.

Medicare reimbursement benchmark definition code#

This code will replace Category III code 0775T. A new Category I code ( 2X000) for percutaneous sacroiliac joint fusion without placement of a transfixion device between the ilium and the sacrum.Four new venography codes for congenital heart defects.

Four new intraoperative ultrasound codes for the heart and aorta, including 7X000 (Ultrasound, intraoperative thoracic aorta, diagnostic), 7X001 (Intraoperative epicardial cardiac ultrasound for congenital heart disease, diagnostic including placement and manipulation of transducer), 7X002 (… placement, manipulation of transducer, and image acquisition only), 7X003 (… interpretation and report, only).Note that CMS refers to them with “dummy codes,” in the proposed rule, though the code descriptions are final.

The proposed fee schedule gives a sneak peek at CPT code additions for next year as CMS proposes valuations for them.