S. SAMUEL BEDERMAN M.D.
NPI 1316190085
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Orange, CA

Medicare Participation & PECOS Enrollment Status

S. Bederman is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

S. Bederman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 1456408434

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20090408000360

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration of bone marrow for spine bone graft

Aspiration of bone marrow for spine bone graft is a procedure where a small amount of bone marrow is extracted, usually from the hip, and then used to help new bone grow in the spine. This can aid in spinal fusion surgeries, enhancing recovery and stability.

This service was performed 39 times for 38 patients

Ct scan of lower spine without contrast

A CT scan of the lower spine without contrast is a non-invasive imaging test. It uses X-rays to create detailed images of your lower back area, helping to detect conditions like fractures, infections, or tumors. It's painless and generally quick.

This service was performed 16 times for 16 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 369 times for 226 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 479 times for 279 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 20 times for 20 patients

Fusion of additional segment of spine

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

This service was performed 50 times for 19 patients

Fusion of lower spine bone through abdomen with partial removal of disc

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

This service was performed 14 times for 14 patients

Fusion of lower spine bone through side with partial removal of disc, 1 bone

This procedure involves merging one bone in the lower spine with another through a side approach. Part of the disc, which acts as a cushion between the bones, is partially removed to help with the fusion. This aims to alleviate back pain and improve spinal stability.

This service was performed 22 times for 22 patients

Fusion of sacroiliac joint obtaining bone graft open procedure

This procedure involves fusing the sacroiliac joint, which connects the spine to the hip bones, to alleviate pain. An incision is made to access the joint, and a bone graft, or transplanted bone, is used to stimulate fusion. This is an open surgery.

This service was performed 16 times for 16 patients

Fusion of spine bones for correction of deformity, posterior approach, 7 to 12 vertebral segments

This procedure involves merging 7 to 12 bones in your spine from the back to correct a deformity. It helps to stabilize your spine, improve alignment, and relieve pain. It's performed under general anesthesia and recovery time varies.

This service was performed 11 times for 11 patients

Fusion of spine in lower back

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

This service was performed 20 times for 20 patients

Harvest of bone fragment for spine bone graft

A harvest of a bone fragment for a spine bone graft is a procedure where a small piece of bone is taken from another part of your body. This bone is then used to help repair or strengthen areas in your spine that may be damaged or weak.

This service was performed 39 times for 38 patients

Imaging guidance for procedure, 60 minutes or less

Imaging guidance is a procedure where real-time images are used to direct medical tools during a treatment. This technique helps to improve accuracy and safety. The procedure typically lasts 60 minutes or less.

This service was performed 98 times for 57 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 16 times for 12 patients

Injection, ketorolac tromethamine, per 15 mg

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

This service was performed 61 times for 12 patients

Insertion of cage or mesh device in disc space during spine fusion

During spine fusion, a cage or mesh device may be inserted into the disc space. This device aids in stabilizing the spine and promoting bone growth for fusion. It's a common and safe procedure used to treat conditions like spinal stenosis or herniated discs.

This service was performed 70 times for 35 patients

Insertion of instrumentation to pelvic bones

This procedure involves placing medical devices into the pelvic bones. It's done to stabilize the bones, aid in healing, or prepare for further treatment. The process is carried out under anesthesia, ensuring comfort and safety throughout.

This service was performed 18 times for 18 patients

Laminectomy or laminotomy (partial removal of spine bones)

A laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.

This service was performed for 81 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

This service was performed 148 times for 60 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

This service was performed 291 times for 80 patients

Mri scan of lower spinal canal without contrast

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

This service was performed 77 times for 74 patients

Mri scan of middle spinal canal without contrast

An MRI scan of the middle spinal canal without contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. This helps doctors identify any abnormalities or issues in your spinal canal. No dye is used in this procedure.

This service was performed 34 times for 34 patients

Mri scan of upper spinal canal without contrast

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

This service was performed 40 times for 40 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 101 times for 101 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 15 times for 15 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 13 times for 12 patients

Partial removal of spine bone with release of middle spinal cord and/or nerves, 1 segment

This procedure involves the partial removal of a spinal bone to alleviate pressure on the spinal cord or nerves. It targets one segment of the spine, enhancing mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 12 times for 12 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

This service was performed 124 times for 22 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 59 times for 40 patients

Placement of stabilizing device to back of 1 spine bone in neck

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

This service was performed 44 times for 43 patients

Placement of stabilizing device to back, 3-6 spine bone segments

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

This service was performed 12 times for 12 patients

Placement of stabilizing device to back, 7-12 spine bone segments

This procedure involves positioning a stabilizing device along your spine's 7th to 12th segments. It's done to support your back and enhance stability, reducing pain and improving mobility. It's a safe, commonly performed surgical procedure.

This service was performed 17 times for 17 patients

Placement of stabilizing device to front, 2-3 spine bone segments

This procedure involves positioning a stabilizing device on the front of 2-3 segments of your spine. It's designed to provide support and stability to your spine, potentially alleviating discomfort and improving mobility.

This service was performed 22 times for 22 patients

Placement of stabilizing device to front, 4-7 spine bone segments

This procedure involves placing a stabilizing device on the front of your spine, specifically between the 4th and 7th bone segments. This helps to support and stabilize your spine, improving alignment and reducing pain or discomfort.

This service was performed 14 times for 14 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

This service was performed 43 times for 41 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

This service was performed 87 times for 30 patients

Removal of deep implant from bone

This procedure involves the careful extraction of an implant deeply embedded in a bone. A specialist makes a small incision, then utilizes precise instruments to reach and safely remove the implant. The area is then closed and monitored for healing.

This service was performed 18 times for 17 patients

Removal of lower spine bone with release of spinal cord and/or nerves, lateral extra cavitary approach, single segment

This procedure involves removing a portion of your lower spine bone to relieve pressure on your spinal cord or nerves. It's performed from the side in a method called the lateral extra cavitary approach, targeting a single spinal segment.

This service was performed 22 times for 21 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 96 patients

X-ray lower and sacral spine, 2-3 views bending views

This procedure involves taking X-ray images of your lower and sacral spine in 2-3 different angles while you bend. It helps in assessing spinal flexibility and identifying any abnormalities or injuries. It's safe, quick, and usually painless.

This service was performed 35 times for 24 patients

X-ray lower and sacral spine, minimum of 6 views

An X-ray of the lower and sacral spine involves capturing images of the bones in your lower back and tailbone area. It helps to identify issues like fractures, infections, or degenerative diseases. A minimum of 6 views ensures a comprehensive examination.

This service was performed 114 times for 111 patients

X-ray of both hips, 2 views

An X-ray of both hips, 2 views, is an imaging test that uses a small amount of radiation to create detailed pictures of your hip joints. This procedure helps to detect fractures, infections, or other abnormalities in the hip area. Two different angles will be captured for a comprehensive assessment.

This service was performed 349 times for 199 patients

X-ray of entire middle and lower spine, 2-3 views

An X-ray of your middle and lower spine involves capturing images of these areas to identify any abnormalities. The procedure involves taking 2-3 different views for a comprehensive understanding. It's non-invasive and usually painless, helping doctors diagnose conditions like fractures or infections.

This service was performed 346 times for 196 patients

X-ray of knee, 1-2 views

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

This service was performed 349 times for 199 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 100 times for 59 patients

X-ray of lower and sacral spine, minimum of 4 views

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

This service was performed 37 times for 36 patients

X-ray of lower leg, 2 views

An X-ray of the lower leg, 2 views, is a quick, painless test that produces images of the bones in your lower leg. It helps to identify fractures, infections, or diseases. Two different angles are used to provide a comprehensive view of the leg's structure.

This service was performed 351 times for 199 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 84 times for 39 patients

X-ray of upper spine, 6 or more views

An X-ray of the upper spine with 6 or more views involves capturing multiple images of your neck and upper back. This non-invasive procedure helps doctors visualize the bones and joints, aiding in diagnosing conditions such as arthritis, fractures, or spinal deformities.

This service was performed 60 times for 60 patients

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 75 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: N/A

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: N/A

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: N/A

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

• Cost Score: N/A

  The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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Frequently Asked Questions