Thus, we recognize hospitals have several options regarding the performance and types of guidance services they use. However, we believe that hospitals utilize the most appropriate form of guidance for the specific procedure that is performed. We do not want to create payment incentives to use guidance for all independent procedures or to provide one form of guidance instead of another. Therefore, by proposing to package payment for all forms of guidance, we are specifically encouraging hospitals to utilize the most cost effective and clinically advantageous method of guidance that is appropriate in each situation by providing them with the maximum flexibility associated with a single payment for the independent procedure.
As a &quot;special&quot; packaged code, if the fluoroscopy service were billed without any other service assigned to status indicator &quot;S,&quot; &quot;T,&quot; &quot;V,&quot; or &quot;X&quot; reported on the same date of service, under our proposal we would not treat the fluoroscopy procedure as a dependent service for purposes of payment.
We expect to carefully monitor any changes in billing practices on a service-specific and hospital-specific basis to determine whether there is reason to request that Quality Improvement Organizations (QIOs) review the quality of care furnished or to request that Program Safeguard Contractors review the claims against the medical record.
Part 1 Proposed Changes to the Hospital Outpatient ...
Proposed Changes to the Hospital Outpatient
System and CY 2008 Payment Rates
Proposed Changes to the Ambulatory Surgical
Center Payment System and CY 2008 Payment Rates