American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Bulletin Advocacy Brief: November 19

SurgeonsVoice Launches Week of Action to Call on Congress to Stop Payment Cuts

The ACS Division of Advocacy and Health Policy (DAHP) continues to call on Congress to stop devastating Medicare payment cuts. With Congress returning from a six-week recess, all Fellows, residents, and surgeons are encouraged to join the week of action to continue to urge lawmakers to act now to stop Medicare payment cuts. This is a triage situation. We need all hands on deck!

To participate in this week of action to capitalize on current U.S. House of Representatives momentum to address this issue prior to January 1 and demonstrate strong support for recent ACS efforts to stop the cuts, surgeons are encouraged to:

  • Follow @SurgeonsVoice, @SurgeonsCare, and @AmCollSurgeons on Twitter to become more educated about ongoing advocacy efforts to stop the cuts and engage with your peers and elected officials via social media. Be sure to reference examples and tag your colleagues, ACS Chapters, and other advocates and encourage them to participate in this collaborative effort.
  • Call your elected officials to relay this important message by phone.
  • Write your lawmakers via SurgeonsVoice.



For other questions, contact ACS DAHP staff at

ACS COT Supported Legislation Passes the House

The Bipartisan Solution to Cyclical Violence Act, H.R. 5855 passed out of the U.S. House of Representatives on Tuesday afternoon. This bill would provide grant funding to create new hospital-based violence intervention programs (HVIP), as well as expand successful programs already in place. In addition, the bill calls for research on best practices, which will play a critical role in documenting the success of these programs and will create a road map for hospitals to follow.

Passage in the House represents months of work by ACS (American College of Surgeons) and Committee on Trauma (COT) fellows who provided data, drafted letters of support, and advocated for the creation of this important program.

Now that this bill has passed the House, attention turns to the Senate where matching language needs to be introduced. Read the ACS COT letter of support. For more information contact Hannah Chargin, ACS Congressional Lobbyist, at

ACS Webinar on 2021 E/M Coding Changes—Register Now!

The American College of Surgeons (ACS) Division of Advocacy and Health Policy (DAHP) invites Fellows to a webinar describing extensive changes to office and other outpatient evaluation and management (E/M) coding rules that will be implemented by the Centers for Medicare & Medicaid Services (CMS) in less than 2 months. Join two surgeons with expertise in general surgery coding and reimbursement, Linda M. Barney, MD, FACS—Associate Professor of Surgery and Director of the Division of General Surgery at Wright State Physicians (Dayton, OH)—and Megan E. McNally, MD, FACS—Assistant Clinical Professor in the Department of Surgery at the University of Missouri-Kansas City School of Medicine—as they outline the new reporting guidelines that will be applied to code selection for office and other outpatient E/M services effective January 1, 2021. Attendees will benefit from insights shared by Drs. Barney and McNally about the revisions made to the office and other outpatient E/M code set by the Current Procedural Terminology (CPT) Editorial Panel, including new requirements related to history and physician examination, physician time, and medical decision making associated with E/M visits. Time will be reserved for Q&A.

Major Changes for 2021 E/M Coding: A Surgeon’s Guide to Prepare for New Guidelines and Avoid Claims Denials
Tuesday, December 1 | 7:00–8:00 pm (CT)


For additional E/M education tools, visit the ACS Office/Outpatient E/M Coding Changes Resource Center. Contact Lauren Foe, Senior Associate for Regulatory Affairs, at with questions.

Mission Critical: Ask your Legislators to Include MISSION ZERO Funding in End of Year Package

The Mission Zero Act, which creates a grant program to assist civilian trauma centers in partnering with military trauma professionals, was signed into law on June 24, 2019 as part of S. 1379, the Pandemic and All Hazards Preparedness and Advancing Innovation (PAHPAI) Act. Since the Mission Zero Act has become law, the ACS has urged Congress to fully fund this critical grant program.

The U.S. House of Representatives included the full $11.5 million in funding in the appropriations package (H.R. 7617) that passed on July 31, 2020. Recently, Senate Republicans released their own draft legislative package but did not include this critical funding for Mission Zero. As negotiations for a final funding package begin between the House and Senate please contact your Representative and Senators and urge them to include the $11.5 million in funding for the Mission Zero grant program.

Find a prewritten letter to your Representatives at SurgeonsVoice.

Learn more about MISSION ZERO. For more information on this effort, contact Hannah Chargin, American College of Surgeons Congressional Lobbyist, at

Deadline for 2020 MIPS Extreme and Uncontrollable Circumstances and Promoting Interoperability Hardship Exception Applications is Approaching!

If you are concerned that the COVID-19 pandemic (or other hardship) has impacted your performance data for the 2020 Merit-based Incentive Payment System (MIPS) performance period, you can submit an exception application until December 31, 2020. Promoting Interoperability (PI) Hardship Exception applications must also be submitted by December 31, 2020. Note that these are separate applications, you can select PI for re-weighting when filling out your Extreme and Uncontrollable Circumstances Exception application, but the PI Hardship Exception is not necessarily related to the impact of COVID-19 and is only available to those who meet one or more of the criteria outlined below as it has been in past years of MIPS.

MIPS Extreme and Uncontrollable Circumstances Exception

By submitting an Extreme and Uncontrollable Circumstances application and citing COVID-19 as the reason for your application, you are eligible to receive reweighting of one or more MIPS performance categories—Quality, Improvement Activities (IA), Cost, Promoting Interoperability (PI)—to 0% of your overall MIPS score. It is important to note—if your application is approved, but you submit data for Quality, PI, or IA, you can still receive a performance score in these categories. So, if you have an approved application and do not want to be scored in those areas for which your application was approved, do not submit data for Quality and IA. However, Cost will not be included in your score if you select the category for reweighting in your application (CMS calculates Cost based on claims so there is no data submission requirement).

MIPS Promoting Interoperability Hardship Exception

MIPS Promoting Interoperability Hardship Exception applications for the 2020 MIPS performance are also due by December 31, 2020. If you are a small practice, have a decertified EHR technology, insufficient internet connectivity, face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues, or lack control over the availability of CEHRT you may qualify for re-weighting of the Promoting Interoperability performance category to 0%.

To submit an Extreme and Uncontrollable Circumstances Exception application or a PI Hardship Exception application sign in to, select ‘Exception Applications’ on the left-hand navigation, select ‘Add New Exception,’ and select ‘Extreme and Uncontrollable Circumstances Exception’ or ‘Promoting Interoperability Hardship Exception.’ To submit these applications a HCQIS Access Role and Profile (HARP) account is required. More information about registering for a HARP account can be found in the QPP Access User Guide.

For more information visit the visit the Promoting Interoperability Hardship Exception and Extreme and Uncontrollable Circumstances Exception QPP webpages for more information and links to each application. CMS also offers an Exceptions Application Fact Sheet that provides more information about these exceptions.

HHS extends compliance dates for information blocking and health IT certification requirements through Interim Final Rule with Comment period (IFC)

In response to the COVID-19 pandemic, the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (health IT) (ONC) released an Interim Final Rule with Comment (IFC) that extends the compliance dates and timeframes to meet requirements related to information blocking and Conditions and Maintenance of Certification (CoC/MoC) requirements established in the 21st Century Cures Act Final Rule. ONC first released the Cures Act Final Rule on March 9, 2020, which established exceptions to the 21st Century Cures Act Information Blocking provisions, adopted new health IT certification requirements, and set compliance dates and timeframes to meet information blocking and CoC/MoC provisions. Due to the disruption caused by the COVID-19 Pandemic, in April 2020 ONC exercised its enforcement discretion by providing an additional three months after the initial deadlines for all new requirements under the ONC Health IT Certification Program (Program).

Within the new Interim Final Rule released on October 29, 2020, ONC extends the Program compliance dates beyond the exceptions announced in April 2020 and establishes new future applicability dates for information blocking provisions. While these rules are primarily directed at developers and vendors of health IT, it is important for surgeons to be aware of the updated compliance dates as well as the requirements under the original 21st Century Cures Act final rules, as they may be the catalyst for updates to your electronic health record software.

ONC provides fact sheets and other resources on the provisions in the 21st Century Cures Act Final Rule, as well as fact sheets on the newly established compliance dates and timeframes in the IFC on their website. All further questions can be directed to