AAHKS comments on CMS outpatient rule, TKA reimbursement change

In a recently issued press release about a CMS final rule to remove total knee arthroplasty from the inpatient only list, the American Association of Hip and Knee Surgeons said it agrees with the CMS’s claim that “the decision regarding the most appropriate care setting for a given surgical procedure is a complex medical judgement made by the physician based on the beneficiaries’ individual clinical needs and preferences.”

Richard Iorio

Under the 2018 Medicare Hospital Outpatient Prospective Payment System Final Rule, Medicare will now reimburse TKA procedures performed on an inpatient or outpatient basis and current procedure terminology code 27447 will be assigned to C-APC 5115 with the status indicator J1.

“We applaud CMS for going slowly with the implementation of same-day discharge TKA for Medicare beneficiaries,” Richard Iorio, MD, AAHKS third vice president-elect, AAHKS Health Policy Council and Advocacy Committee chair and the Advanced Alternative Payment Model Task Force co-chair, told Healio.com/Orthopedics. “We hope as more data is accumulated that CMS allows surgeons and patients to choose the appropriate setting and time of discharge after surgery without reimbursement consequences that create negative incentives. Total hip replacement should also be removed from the inpatient only rule in time after careful analysis.”– by Monica Jaramillo

Reference:

http://www.aahks.org/aahks-news/welcome-to-the-aahks-newsroom/aahks-responds-to-cms-outpatient-rule-and-tka-reimbursement-change/