Learn about Coding Updates, Regulatory Action in 2024 That May Affect Your Practice

The start of 2024 has brought some notable changes to the American Medical Association Current Procedural Terminology (CPT) code set, in addition to the Quality Payment Program (QPP), and the Medicare physician fee schedule (MPFS). The January issue of the Bulletin includes articles on these three areas that outline key changes that surgeons should know about in the coming year.

New 2024 CPT Coding Changes Affect General Surgery, Related Specialties

This article describes CPT 2024 coding changes that are relevant to general surgery and related specialties, and many of the updates for this year are time-based codes. Key areas covered include:

• Hyperthermic Intraperitoneal Chemotherapy
• Evaluation and Management (E/M) and Prolonged Services Codes
• Critical Care Services
• Hospital Inpatient or Observation Care Services for Short Stays
• A look forward to CPT 2025

What’s New for the Quality Payment Program in 2024

The Centers for Medicare & Medicaid Services (CMS) finalized several updates to the participation requirements for year 8 of the QPP. This article highlights the finalized QPP policies that are most relevant to surgeons. Keys areas covered include

• QPP Overview, including information on the Merit-Based Incentive Payment System (MIPS) or Advanced Alternative Payment Model (APM) participation tracks
• MIPS Value Pathway (MVP)
• MIPS Scoring Policies for 2024
• Advanced APMs
• The ACS Perspective on MIPS and the QPP

How Will the 2024 MPFS Affect Your Practice?

New payment policy, coding, and reimbursement changes set forth in the calendar year (CY) 2024 MPFS final rule took effect on January 1. This article focuses on updates that are particularly relevant to general surgery and its related specialties. Key areas covered include:

• E/M Services
  • Split (or Shared) Visits
  • Office and Outpatient E/M Visit “Complexity” Add-On Code
• Telehealth and Telephone Services
• AUC for Advanced Diagnostic Imaging
• Conversion Factor

Additional practice management resources are available on the Practice Management section of the ACS website.

New Article Series Discusses How to “Prevent, Preclude, and Prevail” in Common Liability Claims

In collaboration with The Doctor’s Company, the ACS is providing a new practice management resource. Three P Analysis—Prevent, Preclude, and Prevail is a series of articles based on diagnoses and procedures that are common sources of filing, settlement, or trial of personal injury claims related to surgical care and which can be used to assist surgeons in reducing their risk related to malpractice litigation.

The first article, “Lessons Learned from a Medical Malpractice Lawsuit: Laparoscopic Cholecystectomy Complication,” was written by Ross F. Goldberg, MD, FACS, and David L. Feldman, MD, MBA, CPE, FACS, FAAPL, and provides a narrative retelling of a laparoscopic cholecystectomy, documentation of a complication, signs and symptoms of patient morbidity, follow-up imaging and treatment, and the outcome of the case. 

After the narrative portion, the article offers bullet points on the “Prevent Adverse Events,” “Preclude a Malpractice Case Despite an Adverse Event,” and “Prevail in Lawsuits When a Claim Is Made” steps relevant to the example.

Additional articles will be added in the future. Access and bookmark the series today. 

Train in Advocacy and Put Lessons to Use during Advocacy Summit

Advocating for policies that advance surgery at the local, state, and federal levels is a critical skill as healthcare and surgery face unprecedented challenges in 2024 and beyond. Learn the skills to make advocacy inroads, and then make an impact by meeting leaders from Congress. Register today for the ACS Leadership & Advocacy Summit, April 13–16 at the Westin Washington, DC Downtown Hotel. 

The Summit offers comprehensive and specialized sessions providing ACS members, leaders, and advocates with topics focused on effective surgeon leadership, as well as interactive advocacy training with coordinated visits to Congressional offices.

Train for Advocacy and Meet Lawmakers

The Advocacy Summit will take place Sunday evening, April 14, to Tuesday, April 16, and provides US members with an update on ACS policy priorities. 

In addition to a keynote address on Sunday evening and Monday panel sessions, advocacy training and scheduled congressional visits will be provided as part of the event. ACS staff will send ACS members to the Hill equipped to ask Congress for progress on a range of issues. The ACS will provide more information in the coming weeks.

The Advocacy Summit will be an in-person event with some recorded sessions. There will be no virtual option to view the Advocacy Summit.

Attend the Leadership Summit to Learn Important Skills

Preceding the Advocacy Summit, the Leadership Summit includes 2 days of programming covering an in-depth exploration of leadership principles and offers compelling speakers addressing key topics in surgical leadership.

The Summit starts on Saturday, April 13, with optional sessions that feature new topics on risk management, communications, and challenges in practice management. On Sunday, the traditional programming showcases compelling speakers addressing key themes in surgical leadership. During the Leadership Summit, attendees will learn new and innovative ways to face challenges and enhance their leadership skills, both in and out of the operating room.

The Leadership Summit is a hybrid event with in-person and virtual registration options open to all ACS members and non-members. In-person attendees will experience the onsite program and receive access to livestreamed and on-demand recordings. Virtual attendees will have access to the livestreamed and on-demand content.

Learn more and register today. 

Final Chance: US-Based Residents Can Apply for Leadership & Advocacy Summit Scholarship

The ACS is offering a limited number of scholarships to US-based Resident Members of the College who are interested in attending the Leadership & Advocacy Summit. This scholarship will cover up to $500 in housing and transportation costs. Applications are due Monday, January 22. 

Scholarships will be awarded to a broad representation of all facets of US-based ACS Resident Members, with special consideration for first time attendees of the Leadership & Advocacy Summit, as well as candidates in the senior years of their residency programs.

Recipients must stay for all programming on Sunday, April 14, and Monday, April 15, with preference for those planning to stay through the Congressional Lobby Day on Tuesday, April 16.

Visit the scholarship web page for more information and to apply.

ACS-Led Coalition Urges Passage of PAHPA

The ACS recently led a group of medical organizations in urging Congressional leaders to reauthorize the Pandemic All-Hazards Preparedness Act (PAHPA). 

PAHPA was enacted to improve US response in public health and medical emergencies and was last authorized in 2019. The programs authorized by PAHPA were set to expire on September 30 but were temporarily extended through January 19 as part of the most recent funding agreement. The letter notes that failing to reauthorize PAHPA and adequately support these essential programs would not only hinder effective US response to public health emergencies but would also compromise the progress made in enhancing trauma care capabilities through military-civilian partnerships.

The challenges presented by the COVID-19 pandemic underscore the importance of a robust and comprehensive public health preparedness framework. PAHPA has been instrumental in coordinating federal efforts to enhance our nation's ability in responding effectively to public health emergencies, ensuring that we are adequately prepared to protect the health and safety of our citizens.

Hundreds of organizations have called for the immediate passage and reauthorization of PAHPA and ACS continues to work with Congress and external stakeholders to ensure that PAHPA remains a top priority.

ACS opposes insurer’s policy for coverage of monitored anesthesia care during gastrointestinal procedures

The ACS, along with the American College of Gastroenterology, American Gastroenterological Association, American Society of Anesthesiologists, and American Society for Gastrointestinal Endoscopy recently met with Blue Cross Blue Shield of Massachusetts (BCBSMA) leadership to oppose a new medical policy restricting the use of monitored anesthesia care (MAC) during colorectal and other gastrointestinal procedures.

Effective January 1, BCBSMA will deny payment for the provision of MAC (propofol, for example) unless patients undergoing colonoscopies meet specific risk factor or comorbidity criteria.

The ACS continues urges BCBSMA to rescind this policy, stating that limiting coverage for MAC compromises patient safety, delays access to care, and overrides physicians’ clinical judgment.