reimbursement case

Part 1
A. For the attached list of CPT codes, use the physician lookup function on the CMS website to find the physician reimbursement for each code.

B. Discuss why there is a difference between the facility and non-facility rates for each code.

Part 2
A. For the same codes, use the Calculator 2012 to find the facility reimbursement for an Ambulatory Surgery Center.

B. Discuss the new ASC reimbursement system being phased in beginning January 1, 2008. Provide a history of the payment system. Discuss how and why the new payment system was implemented. Conclude with a discussion on how the new payment system will affect ASCs.

C. Provide a list of the specialties that are winners and losers under the new reimbursement system.

Part 3
Discuss the MS-DRG system for hospital inpatient services. Include in your discussion the history of the MS-DRG system and the need for the updated system. Discuss the pros and cons of the new system.

Submit an MS Excel file containing your analysis of the codes (Parts 1A and 2A). Submit an MS Word file containing your discussions of parts 1B, 2B, 2C and 3. Submit your work to your private bulletin board on or before the due date found on the course calendar.