A heartfelt thank you to the doctors, nurses and all the health care workers and first responders on the front lines working tirelessly to provide quality, compassionate care to patients fighting the Coronavirus.
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COS 2020 Annual Meeting Update
The COS Board is monitoring and evaluating the current pandemic environment as it relates to the COS 2020 Annual Meeting. While we would love to gather together, the Board is reviewing all options.
Please stay tuned for an announcement to be made shortly via an email notification to members.
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COS Receives Cigna Policy Clarification - R30
In March, COS President, Michael Aronow, MD, communicated the Orthopaedic Society's concern regarding
Cigna’s reimbursement policy R30 (Injections and E/M) and the need for clarification of Cigna's previous Policy Update communication.
Cigna responded to the concerns outlined by COS and convened a conference call with Dr. Aronow to discuss the issue. As a result, further clarification was provided due to the confusing initial communication. The information regarding the policy is below. Please contact the COS if you have any additional issues or concerns.
CLARIFICATION - Cigna’s reimbursement policy R30 (Injections and E/M)
- This change does not apply to new patient visit E&M codes. Cigna will pay both the E&M and injection during a new patient visit. This reimbursement policy only applies to established patient E&M codes 99212-99215.
- Cigna's claim system would not deny the E&M with injection when the claim systems determine the patient was not seen previously for the diagnosis for which an injection was performed on the same date of service. This would only deny if there is a prior visit with a same or similar diagnosis. Additionally, if an injection was provided for a patient previously seen by the provider’s partners, the same rules apply as if the patient was seen by the initial provider. In this case, the established patient follow-up visit would be denied if an injection of the same joint occurs on the same date of service.
- If the patient is seen in follow-up related to different parts of the body, such as an E & M code for right knee arthritis and an injection code for left shoulder arthritis, the E&M and injection would both be covered as long as the provider indicates RT/LT, e.g. knee, or the diagnosis codes submitted indicates a different joint, e.g. shoulder.
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COVID 19 - COS Representing the Orthopaedic Community
Since the COVID 19 crises began, the CT Orthopaedic Society has worked diligently to support and represent the orthopaedic community and patients.
We have shared, via email, key economic and financial resources, provided educational webinars on contracting and coding, offered weekly updated telemedicine coding and policy charts* and represented the COS to state agencies and the Governor's Office.
The COS Leadership has been actively involved in sharing concerns with the Governor’s Office on key Executive Orders and represented the Orthopaedic Community during discussions with the Governor’s Reopening CT Task Force as it related to non emergent surgical care.
A brief summary of the Society’s recent work, advocacy and representation, including resource links can be found
here
. For more information, please check the website
www.ctortho.org
for helpful information, resources and timely updates.
As we all continue to do what is right for the safety and health of patients, the COS will continue to represent you, your practice and your patients. If you have any questions or concerns you would like to submit, we will work to find the best resource to help answer your questions and address your concerns. Please forward to the COS via email at
ctorthoexec@gmail.com
. Be well and stay safe.
*
Special thanks to Integrated Physicians Management Services for supplying the coding data and timely policy updates from insurers. For more information: Call: (860) 282-4124
Email
:
contact@ipmscorp.com
CT Legislature
While the 2020 Legislative Session did not reconvene before the May 6
th
constitutional adjournment date, the COS Lobbyist Team at Focus Government Affairs continues to support and advocate for the orthopaedic community and patients including work on the ASCs tax relief and daily updates from the Governor's Office.
For any future legislative action, please check your emails for any legislative news and udpates if the Legislature convenes for a Special Session.
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At the Traveler's Championship, the Foundation WINS with Your Donation!
CT Orthopaedic Society Foundation, Inc. is excited to announce our fundraising partnership with the 2020 Travelers Championship Birdies for Charity program!
Your Donation + 15% Bonus=MORE support for the Foundation.
CT Orthopaedic Society Foundation, Inc. is excited to announce our fundraising partnership with the 2020 Travelers Championship Birdies for Charity program!
Join us in this exciting initiative from now until June 23
rd
With the pandemic restrictions, the
2020 Travelers Championship is still on and is scheduled as a TV-only event, broadcast by CBS and the Golf Channel, June 25–28, 2020.
By raising money through Birdies for Charity, our Foundation receives a 15% bonus on top of all donations. So make your donation go even further by donating through Birdies for Charity.
Your donation will help the Foundation continue its support of Connecticut’s two orthopaedic residency programs and assist other non profit organizations. Since 2003, over $170,000.00 has been donated to Yale and UConn to support the residency education and training donation is simple and easy. Simply log onto our Birdies for Charity donation website or mail in your check contribution using this
form.
Either way, please don’t delay! All donations must be received by June 23
rd
!
Donate here! Thank you!
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CMS AUC Program for Advanced Diagnostic Imaging Begins January 2021
Beginning in January 2021, all physicians will be required to follow the CMS Appropriate Use Criteria for Advanced Diagnostic Imaging.
The COS recommends that all surgeons and their staff familiarize themselves with the AUC Program.
When advanced imaging service is ordered, the AUC Program will require the ordering professional to consult with qualified clinical decision support mechanism (CDSM).
CDSM an interactive, electronic tool used to communicate AUC information to user and assists in making the most appropriate treatment decision for patient’s specific clinical condition during patient workup. The CDSM will provide the ordering physician with score determination of whether the order:
1. Adheres to AUC
2. Does not adhere to AUC
3. If there is no AUC applicable e.g., no AUC is available to address patient’s clinical condition in CDSM.
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