Phasing Out the Global Surgical Package for Physicians

HEALTHCARE Aug 01, 2017 90 minutes
01:00 PM EST 12:00 PM CST 11:00 AM MST 10:00 AM PST

Description:-

The Global Surgical Package (GSP) for the Medicare program has for some time been an issue for doctors in respect to appropriate coding, charging and looking after consistence. To completely comprehend the GSP and then appropriately make use of the modifiers that accompany the GSP needs huge comprehension and study. Furthermore, legitimate procedures and systems must be instituted to perform consistent coding and charging. The RBRVS (Resource Based Relative Value Scale) is likewise influenced by the GSP because the pre-operative, intra-operative, and post-operative portions must be isolated for the purposes purpose of payment. Over the recent years, CMS has come to the realization that there are noteworthy issues with appropriate coding under the GSP. CMS has chosen to eliminate the GSP despite the fact that this change will require huge research and investigation with respect to CMS. The central question is how the GSP can be eliminated without unduly affecting doctors?

  • What is the Global Surgical package idea?
  • Is this a Global Surgeon Package for Medicare?
  • In what way is the global surgical package (GSP) expected to work?
  • In what way should doctors deal with post-operative care in respect to hospitalists?
  • Are E/M services dependably packaged into surgical services?
  • In what way should doctors deal with the transfer of post-operative care?
  • Must doctors make use of the "- 54" modifier?
  • How do the NCCI Coding Policy orders influence the GSP?
  • What is private payer GSPs?
  • What are the services that must be included in surgical payment?
  • How Is CMS altering the MPFS GSP?
  • What should CMS do to eliminate the GSP?
  • How long will it take to eliminate the GSP?
  • What must data gather by CMS so as to eliminate the GSP?
  • What are the problems that CMS must overcome to take out the GSP?

Objective of the session :

  • To appraise the general idea of a global surgical package (GSP).
  • To appraise the Medicare GSP for Use with the Medicare Physician Fee Schedule.
  • To acknowledge how GSPs develop over time.
  • To comprehend the National Correct Coding Initiative (NCCI) strategy declarations for the GSP.
  • To give illustrations and contextual studies on coding for doctors with respect to the Medicare GSP.
  • To appraise the global surgical idea for APCs Ambulatory Payment Classifications.
  • To appraise the global surgical idea for MSDRGs (Medicare Severity Diagnosis Related Groups)
  • To evaluate how those who pay as the third party utilize the global surgical idea.
  • To comprehend the diverse ways that the Medicare program packages or bundles services the in respect to surgeries.
  • To comprehend the best possible utilization of the "- 54", "- 55", and "- 56" modifiers.
  • To acknowledge related procedures, for example, the utilization of the "- 25" and "- 59" modifiers.
  • To comprehend how CMS is in the process of eliminating the GSP.
  • To acknowledge what must be achieved by CMS so as to ascertain that doctors are not unduly influenced by the elimination.
  • To raise the value that must gather in order to eliminate the GSP.
  • To comprehend the difficulties that CMS confronts in eliminating the GDP.

Agenda of the session :

  1. .    Global Surgical Package Concept

    •    Blanket Payment for Surgery

    •    Surgeon Orientation versus Surgery Orientation

    •    Related Anesthesia Package

    •    Differences in GSPs

    2.    Medicare GPS for MPFS

    •    Pre-Operative Period and Services

    •    Intra-Operative Period and Services

    •    Post-Operative Period and Services

    1.    0 Day

    2.    10 Days

    3.    90 Days

    4.    Inside Hospital Post-Operative Care versus Post-Discharge Care

    5.    "- 54", "- 55" and "- 56" Modifiers

    6.    Indicators inside the MPFS

    7.    Transfer of Care for Post-Operative Services

    8.    NCCI Edit Policy Manual Instructions

    9.    Anesthesia Package Idea

    10.    Case Studies and Examples

    11.    Related Surgical Package in Other Payment Systems

    •    MSDRGs – Pre-Admission Window

    •    APCs – Surgical Package

    •    Private Third-Party Payer Use of GSPs

    •    Compliance Concerns

    12.    CMS Eliminates GSP

    •    CMS Activities in Readiness for Elimination

    •    Relative Value Adjustments for Surgeries

    •    Data Collection for Pre and Post-Surgical Services

    •    Considering the Present Misuse of the GSP

    •    Possible Impact on Physicians

    13.    Sources for Further Information

Who should attend ?

  • Physician Coding Personnel
  • Billing and Claims Transaction Personnel
  • Charge-master Coordinators
  • Utilization Review Personnel
  • Financial Analysts
  • Compliance Personnel
  • Physicians
  • Internal Auditing Staff and Other Interested Personnel
Presenter BIO

Duane C. Abbey, Ph.D., is a management consultant and president of Abbey & Abbey, Consultants, Inc. that specializes in health care consulting and related areas. His firm is based in Ames, Iowa. Dr. Abbey earned his graduate degrees at the University of Notre Dame and IowaStateUniversity specializing in mathematics and computer science. Dr. Abbey has published many articles in a variety of professional publications. Also, he has published more than a dozen books on healthcare topics for publishers such as McGraw-Hill, HCPro and Francis & Taylor. Dr. Abbey works extensively in all areas relating to coding, billing and reimbursement. This includes various payment systems, provider-based clinics, HIPAA privacy and security, and revenue enhancement for hospitals and clinics. He has worked extensively with physicians and hospitals. And, yes, his favorite reading material is the Federal Register!

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