After CMS devalued TJA reimbursement in 2019, AAHKS worked diligently with CMS and the RUC to determine how to capture and pay for pre-optimization work by orthopaedic surgeons. In late 2022 CMS approved including knee and hip osteoarthritis pre-optimization work under principal care management (PCM) codes to document this care and regain value within TJA treatment. AAHKS has several resources available to guide orthopaedic surgeons and their staff through this process:
- A recording of the Jan. 30 AAHKS webinar introducing these codes and how to use them is now available on the LEARN educational platform.
- The AAHKS Advocacy Committee and Health Policy Fellows developed this primer to help members navigate utilizing the PCM codes. Access the primer here.
- CMS’s MLN Booklet for PCM Coding
- A recent Amplified podcast on the CMS PRO-PM collection (also known as NQF #3559), which becomes mandatory in April, discusses how collecting PCM codes can assist in the PRO-PM reporting process.
