June, 2012

Over the last few years, pediatricians have gained a lot of ground in the RVU arena - I have documented many of the changes, as you know.  Although it sometimes feels like two steps forward and one step back, the overall RVUs/Visit for PCC client have increased from 1.77 in 2003 to 2.95 in 2012 - although better coding and a smaller Sick:Well visit ratio contribute to that massive change, increased RVUs for imms admins, E&Ms, and well visits have helped a lot.

The big reason for this change, imo, is the ramped-up effort of the AAP in the national arena.  However, they need your help.  They need you to participate in the RUC survey process and get some RVU values for two new key code families that affect you every day: complex chronic care coordination (CCC) and transitional care management (TCM) services!

Here's the note from the AAP.  You only have to donate your time and you will certainly learn something about your practice.  And if you don't participate, you can't complain later that CMS got it wrong.

Dear AAP Members:

We are writing to let you know that the American Academy
of Pediatrics (AAP) and other medical specialty societies will be
conducting an AMA/Specialty Society Relative Value Scale Update
Committee (RUC) survey beginning June 18th.
We will need your input regarding the appropriate valuation of two new
CPT code families for complex chronic care coordination (CCC) and
transitional care management (TCM) services.

The
new CPT codes were approved during the May 2012 CPT Editorial Panel
meeting. The next step is to develop relative value recommendations for
the new codes. Your participation in this process will help ensure that
we present accurate and fair value recommendations to the RUC, which
will then forward its final valuation recommendations to the Centers for
Medicare and Medicaid Services (CMS) for consideration on the Medicare
Resource-Based Relative Value Scale (RBRVS) physician fee schedule.

If you have not completed a RUC survey before, the attached presentation
includes information to help guide you through the process.

If you do not perform these CCC or TCM services, are not a United States physician, or are a commercial representative, please do not
complete the surveys. On the other hand, if you have colleagues
eligible/interested in completing the surveys, you may forward the
surveys to them, provided they meet the aforementioned criteria.

The survey will start on approximately June 18th.
Please expect to receive another e-mail from me at that time, embedded
with a link to the online survey tools. We will be requesting completion
of the surveys by July 2nd.

We look forward to seeking your input. If you have any questions, please contact Linda Walsh, AAP staff, at hidden@email-address.

Thank you for your time and expertise,

Steve Krug, MD, FAAP

AAP RUC Advisor

 

Rich Molteni, MD, FAAP

AAP CPT Advisor

=============================================================================================

Following
is an overview of the services that we’ll be surveying. Thank you in
advance for your time and attention to this important matter.

 

Complex Chronic Care Coordination Services (CCC)

Complex
chronic care coordination services are patient centered management and
support services provided by physicians, other qualified health care
professionals and clinical staff to an individual who resides at home or
in a domiciliary, rest home or assisted living facility. These services
typically involve clinical staff implementing a care plan directed by
the physician or other qualified health care professional. These
services address the coordination of care by multiple disciplines and
community service agencies. The reporting individual provides or
oversees the management and/or coordination of services, as needed, for
all medical conditions, psychosocial needs and activities of daily
living.

 

Transitional Care Management Services (TCM)

Transitional
Care Management codes are used to report transitional care management
services. These services are for an established patient whose medical
and/or psychosocial problems require moderate or high complexity medical
decision making during transitions in care from an inpatient hospital
setting (including acute hospital, rehabilitation hospital, long-term
acute care hospital), partial hospital, observation status in a
hospital, or skilled nursing facility/nursing facility, to the patient’s
community setting (home, domiciliary, rest home, or assisted living).
TCM commences upon the date of discharge and continues for the next 29
days.

 

Jose F. Lopez

Manager, Practice Management

American Academy of Pediatrics

847/434-4089

Your opportunity to participate in the RUC surveys is open and ends on 07/10/12...so get on it!
This is the latest from the AAP:

As indicated in my previous e-mail on June 14th [embedded below], I am
now sending you the survey links for the following RUC valuation
surveys:

Transitional Care Management CPT Codes (TCM) [2 codes]
https://www.surveymonkey.com/s/TCMServices2012

Chronic Complex Care Coordination CPT Codes (CCC) [3 codes]
https://www.surveymonkey.com/s/CCCCServices2012

If you do not perform these CCC or TCM services, are not a United States
physician, or are a commercial representative, please do not complete
the surveys.

A week or so ago, Dr. David Horowitz from NC, posted the following message to SOAPM:

I briefly posted a week or 2 ago about an article in Pediatrics (Last November, Supplement 4) devoted to CAM that focused on anti-vaxers. The feeling was that a lot of the points the authors made were unrealistic and not grounded in reality. I have composed a formal response to this article that I would like to submit to Pediatrics as reflecting the view point of the pediatrician in private practice and not the isolated ivory tower view point of ethicists, lawyers, and internists (i.e. the authors of the article, not one of whom is a practicing pediatrician, as far as Google can tell me)...I believe a response such as mine will be a start in telling the editors what is important to us. To that end, I think this would be a much more powerful statement if it came from the Section rather than me as an individual. So please chime in as to whether you would be either willing to put your name on this as a individual supporter and whether you think this should be sent on the SOAPM letterhead. This listserve is about as close to polling the membership on this or any other issue.

The letter is here.

Dozens of SOAPM members have written to express their desire to be signed to the bottom of the letter, so I thought to share it here. If you are interested in being attached, send me an email, and I will forward it to Dr. Horowitz (I'm trying not to blast his email to the world).

I know that a few small changes were requested and I don't know the status of the latest draft, I'm sure he'll be glad to share it. 

My sincere congratulations go to Dr. Ed Zissman, the 2012 Charles "Buzzy" Vanchiere Award winner.  PCC is delighted to sponsor the award every year.

On behalf of the American Academy of Pediatrics Section on Administration and Practice Management, I would like to congratulate Edward Zissman, MD, FAAP on being selected to receive the 2012 Charles “Buzzy” Vanchiere Award! This award recognizes a pediatrician who has made outstanding contributions toward helping pediatricians build effective managerial skills and providing training and tools for fellows to negotiate preferential use of pediatric care and appropriate compensation.

The award will be presented during the 2012 AAP National Conference and Exhibition (NCE) in New Orleans, LA at the Vanchiere Award Luncheon. Details on the Vanchiere Award Luncheon with information on how to attend will be sent shortly.

Please join me in congratulating Dr Zissman as the 2012 Charles "Buzzy" Vanchiere Award recipient.

Edward Zissman, MD, FAAP has been voted the 2012 recipient of the Buzzy Vanchiere Award for outstanding service and achievement in pediatric practice management. Dr. Zissman’s leadership within the AAP began with chairing the Florida AAP’s committee on child health care finance.

He was instrumental in forcing the state of Florida to provide equal access to children’s health services through fair payments and adequate networks in the Medicaid system. At the national level, Dr. Zissman has served as the chair of the original AAP CPT Coder’s Training Network, and served on the executive committees of both the Section on Administration and Practice Management (SOAPM) and the Committee on Child Health Care Finance (COCHF). He served as Vice-Chair for District X from 2008 to 2011. Most recently, he has forged an alliance between the AAP, CDC, FDA and the vaccine pharmaceutical companies to implement two dimensional bar coding of vaccines in his role as vice-chair of the AAP’s ad hoc committee on vaccine bar coding.

Dr. Zissman is tireless in his efforts to promote the highest quality pediatric care to children and best practices in pediatric practice
management.