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American Association of Hip and Knee Surgeons

Advocacy, Education, Research

‘Practice Management’

Arthroplasty Today Publishes First White Paper

The September edition of Arthroplasty Today features the first white paper published in the open-access journal. “Help, my rating looks bad! Coding comorbidities in arthroplasty,” by Joseph W. Galloway, MD and Frank R. Voss, MD. Dr. Voss is Chair of the AAHKS Practice Management Committee, and this white paper represents work endorsed by that committee. The paper outlines… Read More

Orthopedics This Week Features Quality Collaboration

Orthopedics This Week interviewed Daniel J. Berry, MD, American Joint Replacement Registry (AJRR) Board of Directors member and AAHKS Past President, regarding the collaboration between AAHKS, the AJRR and The American Orthopaedic Association which aligns our quality initiatives and reporting through the AJRR’s Orthopaedic Quality Resource Center. “At the heart of our Registry, we’ve always strived to be as… Read More

Keep in Touch with AAHKS Regarding Precertification Programs

We are collecting feedback on issues with precertification and utilization review processes for all payors. AAHKS leaders meet periodically with CMS and insurance companies to address your concerns. Let us know if your staff experienced denials or delays in authorization by emailing Joshua Kerr, Director of Advocacy and International Activities at jkerr@aahks.org.

Keep in Touch with AAHKS Regarding New Cigna Precertification

Cigna (through eviCore) has implemented a pre-certification process for total joint arthroplasty patients. To access the Cigna/EviCore approval process, visit https://myportal.medsolutions.com or call 888-693-3297. If your staff has problems getting cases approved in a timely fashion, it is essential that that you make this clear to eviCore and Cigna. It is also essential that you inform AAHKS if… Read More

CMS Reports Fraction of ICD-10 Claims Rejected

Healthcare Finance News reports that of the 10 percent of claims filed under ICD-10, only a fraction have been rejected by CMS due to coding errors. Rejections were DUE to incorrectly submitted ICD-9 codes and incomplete or incorrect information. The article points out, “Since the transition, claims are processing normally. Medicare claims take several days to be processed… Read More

Cigna Announces Precertification Program for Arthroplasty

Cigna has announced that it will implement a musculoskeletal precertification program beginning January 1, 2016. According to a letter sent to AAHKS, “ordering physicians will need to request precertification directly through eviCore for certain musculoskeletal services, including interventional pain management and major joint surgery services related to the hip, knee, and shoulder.” Cigna has partnered with eviCore Healthcare… Read More

Taking HIPAA Seriously

A recent $750,000 settlement between the Department of Health and Human Services and a physician group stands as a reminder that HIPAA compliance must be taken seriously. The new AAHKS Advocacy firm, Epstein Becker & Green, takes a look at this case and the lessons that can be learned. “The penalty and corrective action plan serve as a… Read More

Visit the New AAHKS ICD-10 Resource Center

With the Centers for Medicare and Medicaid Services (CMS) implementation of ICD-10 starting on October 1, 2015, AAHKS has compiled several resources to help ease the transition. ICD-10 expands the number of codes from 16,000 to 68,000 from the previous iteration, and although claims will not be denied because of miscoding for a period of 12 months, this… Read More

Payment Model for Hip and Knee Replacements Proposed

The Centers for Medicare and Medicaid Services (CMS) proposed an extensive “pilot” of a new Medicare Part A and B payment model, “Comprehensive Care for Joint Replacement (CCJR) Model” under which acute care hospitals in geographic areas covering about 25% of patients will receive retrospective bundled payments for episodes of care for hip and knee replacement surgery. The… Read More

ACR Seeks Letters of Interest for Perioperative Management Guideline Development

The American College of Rheumatology (ACR) invites letters of interest from those who wish to partner with ACR and AAHKS to develop evidence-based clinical practice guidelines for perioperative management of rheumatic disease medications in total joint arthroplasty of the hip and knee. The guidelines will be developed primarily for orthopaedic surgeons and rheumatologists who care for patients undergoing total joint… Read More