News | Cath Lab | January 30, 2018

SCAI Advocacy Committee Highlights Reimbursement Reform Efforts in 2017

Association helped generate new CPT codes for interventional cardiology procedures, worked with private and government insurers to protect reimbursement

SCAI Advocacy Committee Highlights Reimbursement Reform Efforts in 2017

January 30, 2018 — The Society for Cardiovascular Angiography and Interventions (SCAI) highlighted the efforts of its Advocacy Committee in 2017 to push healthcare reform forward, spotlighting the committee’s role in protecting reimbursement rates for interventional cardiology procedures.

Highlights of the Advocacy Committee’s actions in 2017 included:

  • As a direct result of SCAI’s advocacy efforts, the Centers for Medicare and Medicaid Services (CMS) vacated their proposal to “blend” the cardiology malpractice factor used in rate setting under the Medicare Physician Fee Schedule Final Rule that would have resulted in across-the-board cuts of ~10 percent for all interventional cardiology procedures;
  • SCAI successfully retained its American Medical Association (AMA) House of Delegates seat, ensuring continued direct representation for interventional cardiology in the AMA Current Procedural Terminology (CPT) Editorial Panel and Resource-Based Relative Value Scale (RBRVS) Update Committee, the processes by which new codes are granted and new/existing codes are valued;
  • New Category I CPT codes, crafted and secured by SCAI for Paravalvular Leak Closure and Left Atrial Appendage (LAA) Occlusion procedures, went into effect on Jan. 1, 2017;
  • New category III CPT codes, crafted and secured by SCAI for Transcatheter Mitral Valve Implantation/Replacement, were released by the AMA on July 1, 2017;
  • CMS elected to cancel the Acute Myocardial Infarction (AMI)-Percutaneous Coronary Intervention (PCI) Bundled Payment Program, after SCAI identified significant concerns;
  • SCAI was successful in ending the long-standing confusion over inpatient status for AMI-PCI patients, by successfully adding the AMI-PCI CPT code to CMS’ “inpatient only” list;
  • The association successfully engaged major insurance carriers to secure and expand coverage for interventional cardiology procedures; and
  • A Pediatric Interventional Cardiology Coding & Reimbursement Workgroup has been convened by SCAI to address the unique needs and challenges SCAI members face in this space.

The association now asking all members to take a few minutes to complete a short survey regarding healthcare reform and bundled-payment programs. This survey will help guide SCAI’s Advocacy Committee in crafting an agenda for 2018.

Take the survey here

Watch the VIDEO: Converting to Bundled Payments for PCI — a discussion with Peter L. Duffy, M.D., MMM, FACC, FSCAI CPE, interventional cardiologist and former director of quality for the cardiovascular service line at FirstHealth of the Carolinas Reid Heart Institute, at Moore Regional Hospital in Pinehurst, N.C. He spoke on a cath lab management class sponsored by SCAI at TCT 2017. 


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