Jones Christopher A, Acevedo Jean, Bull Janet, Kamal Arif H
1 Main Line Health , Radnor, Pennsylvania.
2 Lankenau Medical Center , Wynnewood, Pennsylvania.
J Palliat Med. 2016 Dec;19(12):1249-1253. doi: 10.1089/jpm.2016.0202. Epub 2016 Sep 28.
Although recommended for all persons with serious illness, advance care planning (ACP) has historically been a charitable clinical service. Inadequate or unreliable provisions for reimbursement, among other barriers, have spurred a gap between the evidence demonstrating the importance of timely ACP and recognition by payers for its delivery. For the first time, healthcare is experiencing a dramatic shift in billing codes that support increased care management and care coordination. ACP, chronic care management, and transitional care management codes are examples of this newer recognition of the value of these types of services. ACP discussions are an integral component of comprehensive, high-quality palliative care delivery. The advent of reimbursement mechanisms to recognize these services has an enormous potential to impact palliative care program sustainability and growth. In this article, we highlight 10 tips to effectively using the new ACP codes reimbursable under Medicare. The importance of documentation, proper billing, and nuances regarding coding is addressed.
尽管预先护理计划（ACP）被推荐给所有患有严重疾病的人，但从历史上看，它一直是一项慈善性临床服务。报销规定不足或不可靠等诸多障碍，导致了在证明及时进行ACP的重要性的证据与支付方对其实施的认可之间出现了差距。医疗保健首次在计费代码方面经历了巨大转变，这些代码支持加强护理管理和护理协调。ACP、慢性护理管理和过渡性护理管理代码就是对这类服务价值的这种新认可的例子。ACP讨论是全面、高质量姑息治疗的一个组成部分。认可这些服务的报销机制的出现，对姑息治疗项目的可持续性和发展具有巨大的潜在影响。在本文中，我们重点介绍了有效使用医疗保险可报销的新ACP代码的10个小贴士。文中还讨论了文件记录、正确计费以及编码细微差别的重要性。
