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The Omnibus Budget Reconciliation Act of 1989 enacted a Medicare fee schedule, and as of 2010 about 7,000 distinct physician services were listed. [2] The services are classified under a nomenclature based on the Current Procedural Terminology (CPT) to which the American Medical Association holds intellectual property rights. [ 2 ]
For example, in 2005, a generic 99213 Current Procedural Terminology (CPT) code was worth 1.39 Relative Value Units, or RVUs. Adjusted for North Jersey, it was worth 1.57 RVUs. Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50.
It is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code. [19] In the past, AMA offered a limited search of the CPT manual for personal, non-commercial use on its web site. [20] CPT codes can be looked up on the AAPC (American Academy of Professional Coders) website. [21]
Balloon Eustachian tuboplasty (BET) [1] is a minimally invasive procedure for the causal treatment of Eustachian tube dysfunction (ETD), an often-chronic disorder in which the regulation of middle ear pressure and the removal of secretions are impaired. The dysfunction often causes significant discomfort in affected patients and can trigger ...
The surgery takes 1 ⁄ 2 to 1 hour if done through the ear canal and 1 + 1 ⁄ 2 to 2 hours if an incision is needed. It is done under local or general anesthesia . It is done on an inpatient or day case basis and is successful 85–90% of the time.
Keratosis obturans is a relatively uncommon ear disease, where a dense plug of keratin, formed by abnormal accumulation of desquamated skin in sheet-like layers , forms in the bony (deeper) part of the external auditory canal. [1]
A mastoidectomy is a procedure performed to remove the mastoid air cells [1] near the middle ear. The procedure is part of the treatment for mastoiditis, chronic suppurative otitis media or cholesteatoma. [2] Additionally, it is sometimes performed as part of other procedures, such as cochlear implants, [3] or to access the middle ear.
APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...