The American Society for Gastrointestinal Endoscopy (ASGE), American College of Gastroenterology (ACG) and American Gastroenterological Association (AGA) have stated that they will fight cuts to reimbursement rates for colonoscopy and other lower gastrointestinal endoscopic procedures proposed by the Centers for Medicare & Medicaid Services (CMS) for 2016.
If unchanged, the 2016 Medicare Physician Fee Schedule (MPFS) would cut physician work values for the colonoscopy family by up to 19%.
In a joint statement, the ASGE, ACG and AGA asserted that the proposed rates for the colonoscopy code family are not based on data, and described the methodology used to determine physician work and intensity for these services as “severely flawed.”
Gastroenterology & Endoscopy News, July 13, 2015
ACG and the GI societies are committed to fighting the proposed cuts to reimbursement rates for colonoscopy and other lower GI endoscopy procedures. We are scheduled to meet with CMS leadership next week. ACG continues to urge members of Congress to help oppose these cuts as well as cosponsor the SCREEN Act (S. 1079; HR 2035), which would maintain colonoscopy reimbursement at the 2015 levels and until the Medicare fee for service reimbursement system changes take place beginning in 2019. The SCREEN Act is currently the only legislation that deals with these changes to colonoscopy reimbursement. Read my full post
What You Can Do
ACG wants to share with CMS officials next week data on how cuts of up to 19 percent will affect GI practices. Please take the time and complete this quick poll and help us fight for fair reimbursement for you.
From the ACG Blog, July 17, 2015
By: Caroll D. Koscheski, MD, FACG, National Affairs Committee Chair
I am incredibly frustrated and disappointed today. Devastating cuts to reimbursement for lifesaving colonoscopy exams under Medicare’s Physician Fee Schedule are proposed despite advocacy by ACG and its sister GI societies in the past few years.
I want the GI community in the United States to understand the fundamental lack of fairness which underlies the process that got us to this cut. The process is flawed. The outcome is flawed. Worst of all, we risk a reversal of the progress our nation is making to increase use of colorectal cancer screening by colonoscopy for Medicare beneficiaries, who by virtue of their age, are at higher risk for colorectal cancer. Read full post.
From the ACG Blog, July 9, 2015
By: Stephen B. Hanauer, MD, FACG, ACG President
In response to concerns from ACG and the provider community, the Centers for Medicare and Medicaid Services (CMS) this week released additional guidance that will allow for flexibility in the claims processing and quality reporting process as the new ICD- 10 code set begins October 1, 2015. Medicare claims processing systems will not have the capability to accept ICD-9 codes for dates of services after September 30, 2015, nor will they be able to accept claims for both ICD-9 and ICD-10 codes.
From the ACG Blog, July 7, 2015
By: Carroll Koschescki, MD, FACG, National Affairs Committee Chair.
The colonoscopy: It may be the most dreaded screening test out there, and it’s the next step in KQED’s PriceCheck project.
On PriceCheck, we’re crowdsourcing prices of common health tests and procedures. KQED, along with our colleagues at KPCC in Los Angeles and ClearHealthCosts.com, a health cost transparency startup in New York, are asking people in California to share what they’ve paid for various health care procedures.
Patient safety is a primary concern for gastrointestinal endoscopists. You may have recently heard or read about the spread of infection by Carbapenem-Resistant Enterobacteriaceae (CRE) through a procedure called ERCP. ERCP stands for endoscopic retrograde cholangiopancreatography. It is an advanced highly technical endoscopic procedure.
The vast majority of people will never have an ERCP. For patients who do need it, ERCP is a critical and potentially life-saving procedure.
Patients are reminded that the therapeutic benefit of ERCP usually outweighs the potential low risk of infection and that they should talk to their doctors about any concerns. ACG has been working with – and will continue to work with – the leadership of all other GI societies, the Centers for Disease Control & Prevention (CDC), the Food and Drug Administration (FDA), manufacturers and other groups to evaluate and address this complex issue.
Updated Quality Indicators for GI Endoscopic Procedures published online today. The ASGE/ACG Task Force on Quality in Endoscopy has updated quality indicators common to all gastrointestinal endoscopic procedures and for the four major endoscopic procedures: colonoscopy, esophagogastroduodenoscopy (EGD, also known as upper endoscopy), endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS). These documents are published online in GIE: Gastrointestinal Endoscopy and The American Journal of Gastroenterology.
John Swartzberg, MD discusses the reasons why the U.S. Preventive Services Task Force, American College of Gastroenterology and American Cancer Society do not recommend virtual colonoscopy–and why colonoscopy is the recommended colorectal cancer prevention test.
Visit the American College of Gastroenterology’s new blog for all the latest highlights from the 2014 Annual Scientific Meeting including featured abstracts with author commentary, expert insights. virtual press briefings and more.
Virginia gastroenterologists Dr. David Balaban and Dr. David Johnson authored an op-ed to counter a recent Huffington Post blog post about CT colonography. They review the evidence in their piece, “Five Reasons Why Colonoscopy is Better than CT Colonography.” The Huffington Post/Post50 (9/12)