AAOS UPDATE

There has been tremendous activity at the AAOS on behalf of orthopaedic surgeons including work through the Coding, Coverage, and Reimbursement Committee, the development of a practice management self-assessment examination, new CME course offerings for 2008, and public relations materials to educate children about musculoskeletal health.  In addition, information is available on how to participate in the 9th safe, accessible playground build in San Francisco, California. 

2007 Coding, Coverage and Reimbursement Committee Activities
The AAOS Coding, Coverage and Reimbursement Committee is responsible for all coding and reimbursement activity on behalf of the AAOS.  The Committee is the vehicle for CPT and Medicare reimbursement activities.

This fall, the AAOS presented four separate CPT proposals at the October CPT Editorial Panel meeting.  If accepted, one of these proposals will greatly improve the tumor section of the CPT coding system.  The AAOS expects the CPT Editorial Panel to complete its work on this proposal in February after which it will be sent to the AMA/Specialty Society Relative Value Scale Update Committee (RUC) for evaluation under the Medicare system.   Please look for notices from the AAOS asking for orthopaedists to complete surveys on these codes to help with the RUC/Medicare evaluation process.

The AAOS also submitted Code Change Proposal forms for three additional orthopaedic procedures: Buttock Fasciotomy, Computer Dependent External Fixation and Thigh Transplant or Transfer.  The AAOS is currently conducting work surveys for the Buttock Fasciotomy and Computer Dependent External Fixation codes and will present survey results to the RUC Panel at the February 2008 RUC Panel meeting.

The AAOS presented work RVU recommendations for five musculoskeletal CPT codes at the 2007 September RUC Panel meeting.  Three of these CPT codes were for Femoral Head Fracture treatment and two were for imageless Computer Assisted Surgical Navigation.  The recommendations made by the AAOS were accepted by the RUC and CMS and are part of the 2008 Medicare Physician Fee Schedule published in November 2007.  The AAOS is currently conducting several work value surveys and will present the results of these surveys, along with work RVU recommendations at the February 2008 RUC Panel meeting.

The AAOS has also been actively analyzing the 2008 Physician Fee Schedule, released on November 1, 2007.  The fee schedule includes many changes relevant to Medicare reimbursement for orthopaedic surgeons.  The most significant are the proposed cuts in Medicare reimbursement dictated by the Sustained Growth Rate (SGR).  This is the same proposed cut that Congress overturned the last two years.  Congress recently passed a 6 month SGR freeze and will consider additional action to remedy SGR cuts in 2008.  The AAOS encourages all orthopaedic surgeons to contact their Congressional representatives urging them to reverse these cuts. 

In addition, CMS tightened anti-markup provisions that would limit the ability of orthopaedic surgeons to own and operate MRI centers outside their office.  The AAOS is encouraging Congress and CMS to reconsider these provisions. 

Finally, look for over 20 new CPT procedure codes for orthopaedic procedures, as well as approximately 70 revised RVU packages for orthopaedic procedures.  The AAOS presented recommended work RVUS for 62 fracture care procedure codes and CMS did not agree with these 62 recommendations.  The AAOS is engaged in discussions with CMS about these procedure code values and the AAOS encourages all orthopaedic surgeons to contact CMS expressing their concern.

If you have any questions regarding any of these codings and Medicare reimbursement issues, please feel free to contact Matthew Twetten, Senior Policy Analyst at twetten@aaos.org.

AAOS Develops 2007 Online Practice Management Self Assessment Examination
An AAOS editorial board of orthopaedic surgeons and professional practice management consultants has developed a 100-item Practice Management Examination.  The examination content covers a wide-range of issues affecting the business operations of orthopaedic practices, such as coding/reimbursement, financial and personnel management, practice enhancements, government compliance, practice governance, liability management, occupational health, information and facility management and medical ethics.  Questions are written in case scenario style with five responses.  The preferred response, a discussion, and references to support the response are included with each question.

The American Academy of Orthopaedic Surgeons designates this educational activity for a maximum of 10 AMA PRA Category 1 Credits™.  Physicians should only claim credits commensurate with the extent of their participation in the activity. 

The examination can also be purchased in print format.  For more product information and to order either the online or print version, visit the AAOS Web site.  A special introductory rate of $60.00 applies through March 31, 2008.  Questions can be directed to Customer Service via email (custserv@aaos.org) or by telephone at Monday-Friday, 8AM-5PM CST US and Canada: 800-626-6726, International++847-823-7186.

AAOS 2008 CME Courses
The AAOS will be presenting the following CME courses from January – April, 2008. 
Some courses are jointly sponsored with orthopaedic specialty societies. 

  • AAOS/ASES Open and Arthroscopic Techniques in Shoulder

January 18 – 19, Orthopaedic LearningCenter, Rosemont, IL

  • 9th Annual AAOS/AOSSM Sports Medicine Course: Treating Amateur to All-Star

Feb 7 - 10, Phoenix, AZ

  • AAOS Current Techniques in Reconstructive Foot and Ankle Surgery

February 8 – 9, Orthopaedic LearningCenter, Rosemont, IL

  • 6th Biennial AAOS/ASES Shoulder and Elbow: Current Techniques and Controversies Apr 03 to Apr 06, Orlando, FL
  • AAOS Knee Injuries in Athletes: Getting Patients Back in the Game; Cutting Edge Techniques Apr 03 to Apr 05, Orthopaedic Learning Center, Rosemont, IL
  • AAOS presents Boomeritis®: Musculoskeletal Care of the Mature Athlete

Apr 17 to Apr 19, Hilton Head Island, SC

  • 8th Annual AAOS/OTA Orthopaedic Trauma Update

Apr 24 to Apr 27, Saint Augustine, FL

For more information about these courses, including the daily course schedule, visit www.aaos.org.

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Virginia Orthopaedic Society
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