A group of physicians and researchers examined the financial impact of third-party reimbursement as the definition for the ICD-9 arthroscopy code changed over time and published their results in The Journal of Bone & Joint Surgery.
The ICD-9 codes for partial medial and lateral meniscectomy as well as partial medial or lateral meniscectomy decreased from 2011 to 2012. At the he same time, the codes for debridement or shaving articular cartilage and debridement of articular cartilage or removal of foreign/loose body in a separate compartment were bundled.
These changes had an impact on physician reimbursement as well as coding patterns. The researchers examined a language database for ICD-9 coding and third-party reimbursement for a large group practice. The researchers found:
1. Average third party reimbursement for partial medial and lateral meniscectomy decreased from $734.33 in 2011 to $630.40 in 2012.
2. For partial medial or lateral meniscectomy, third party reimbursement decreased from $709.17 in 2011 to $$639.18
3. The average reimbursement for partial medial and lateral meniscectomy and debridement or shaving articular cartilage decreased from $995.07 in 2011 to $630.40 in 2012.
4. There were similar decreases for patients who underwent partial medial or lateral meniscectomy and debridement or shaving articular cartilage.
5. The average Medicare payment for partial medial and lateral meniscectomy and debridement or shaving articular cartilage was $749.58 in 2011 and $532.71 in 2012.
6. Medicare reimbursement for patients who underwent partial medial or lateral meniscectomy and debridement or shaving articular cartilage fell from $704.11 in 2011 to $527.04 in 2012.
7. The number of total knee arthroscopy cases with debridement or shaving articular cartilage code was down from 2,710 times in 2011 to 348 times in 2012.
8. At the same time, the limited synovectomy code use increased from 247 times in 2011 to 467 times in 2012.
9. The use of the major synovectomy code was up 4.88 percent, increasing from 852 uses in 2011 to 874 uses in 2012.
10. Abrasion arthroplasty or microfracture code use was up 1 percent from 119 times in 2011 to 143 times in 2012.
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The ICD-9 codes for partial medial and lateral meniscectomy as well as partial medial or lateral meniscectomy decreased from 2011 to 2012. At the he same time, the codes for debridement or shaving articular cartilage and debridement of articular cartilage or removal of foreign/loose body in a separate compartment were bundled.
These changes had an impact on physician reimbursement as well as coding patterns. The researchers examined a language database for ICD-9 coding and third-party reimbursement for a large group practice. The researchers found:
1. Average third party reimbursement for partial medial and lateral meniscectomy decreased from $734.33 in 2011 to $630.40 in 2012.
2. For partial medial or lateral meniscectomy, third party reimbursement decreased from $709.17 in 2011 to $$639.18
3. The average reimbursement for partial medial and lateral meniscectomy and debridement or shaving articular cartilage decreased from $995.07 in 2011 to $630.40 in 2012.
4. There were similar decreases for patients who underwent partial medial or lateral meniscectomy and debridement or shaving articular cartilage.
5. The average Medicare payment for partial medial and lateral meniscectomy and debridement or shaving articular cartilage was $749.58 in 2011 and $532.71 in 2012.
6. Medicare reimbursement for patients who underwent partial medial or lateral meniscectomy and debridement or shaving articular cartilage fell from $704.11 in 2011 to $527.04 in 2012.
7. The number of total knee arthroscopy cases with debridement or shaving articular cartilage code was down from 2,710 times in 2011 to 348 times in 2012.
8. At the same time, the limited synovectomy code use increased from 247 times in 2011 to 467 times in 2012.
9. The use of the major synovectomy code was up 4.88 percent, increasing from 852 uses in 2011 to 874 uses in 2012.
10. Abrasion arthroplasty or microfracture code use was up 1 percent from 119 times in 2011 to 143 times in 2012.
More articles on orthopedic surgery:
Drs. Mark Floyd, Charles Pesson join Harbin Clinic
Dr. Srinivas Ganesh joins Kesinski Clinic Orthopedics
10 orthopedic surgeons making headlines this week