Posts Tagged ‘ASC’

Cardiac computed tomography (CCT) professionals will see major changes in coding next year. CPT® 2010 adds four new Category I codes to report CCT and cardiac computed tomography angiography (CCTA) services and deletes four Category III codes.

In a statement posted on its Web site prior to the Oct. 30 release of the 2010 Outpatient Prospective Payment System (OPPS) final rule, the Society of Cardiovascular Computed Tomography (SCCT) said it did not foresee significant changes in payment for CCT/CCTA. They were singing another tune Nov. 2.

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Hospitals who successfully participated in quality data reporting for outpatient services will receive a 2.1 percent inflation update in their 2010 payment rates for services furnished to Medicare beneficiaries in outpatient departments, according to the Centers for Medicare & Medicaid Services (CMS). Ambulatory surgical centers (ASCs) will receive a 1.2 percent inflation update beginning Jan. 1, 2010 using the same payment methodology as in 2009.

These and other payment and policy changes can be found in the 2010 Hospital Outpatient Prospective Payment System (OPPS) and ASC final rule with comment period — put on display for review Oct. 30.

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The Office of Inspector General (OIG) released, Oct. 1, its annual Work Plan for fiscal year 2010. The Work Plan outlines activities the OIG intends to initiate or continue in its ongoing endeavor to right wrongs in Health and Human Services (HHS) programs and operations, such as Medicare. Read more »

Changes to the Inpatient Prospective Payment Systems (IPPS) for acute care and long-term care hospitals and 2010 payment rates were published in a final rule Aug. 27 in the Federal Register. Read more »

A nationwide effort to lower health care associated infections (HAIs) in ambulatory surgical centers (ASCs) will begin later this month. Twelve states will survey more than 125 local ASCs before Sept. 30, at an estimated cost of $1 million, to identify why there has been an increase in HAIs and what can be done to prevent them, according to a Centers for Medicare & Medicaid Services (CMS) July 30 press release.

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Medicare Administrative Contractor (MAC) First Coast Service Options (FCSO) has posted on its Web site local coverage determination (LCD) revisions, most of which are effective for claims processed on or after July 6, for services rendered on or after July 1. Providers and staff serving Medicare patients in Florida, Puerto Rico, and the U.S. Virgin Islands (jurisdiction 9) should familiarize themselves with these changes.

Skin Substitute LCD (L28985 and L29279)

Codes added to the noncovered products section of this LCD include HCPCS Level II codes C9363, J3590, and Q4115.

C9363 - Skin substitute, Integra Meshed Bilayer Wound Matrix, per square centimeter (ASC only)
J3590 – Skin substitute, Integra Meshed Bilayer Wound Matrix, per square centimeter (Provider only)
Q4115 - Skin substitute, alloskin, per square centimeter

FCSO has also revised its list of noncovered Medicare services (LCD L29288 and L29398) to incude the following newly-added CPT® codes:

Local Noncoverage Decisions – Devices

CPT® code 0199T Physiologic recording of tremor using accelerometer(s) and gyroscope(s), (including frequency and amplitude) including interpretation and report

Local Noncoverage Decisions – Drugs and Biologicals

CPT® code 90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular use

Local Noncoverage Decisions – Procedures

CPT® code 0202T Posterior vertebral joint(s) arthroplasty (e.g. facet joint[s] replacement) including facetectomy, laminectomy, foraminotomy and vertebral column fixation, with or without injection of bone cement, including fluoroscopy, single level, lumbar spine

Local Coverage Decision

The non-surgical Renessa® treatment, represented by CPT® code 0193T Transurethral, radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence and ICD-9-CM code 625.6 Stress urinary incontinence, female, is indicated for the transurethral treatment of female stress urinary incontinence (SUI) due to hypermobility in women who have failed conservative treatment and who are not candidates for surgical therapy.

FCSO has removed 0193T from its list of noncovered Medicare services and will consider reimbursement of this code on a case-by-case basis only.

To ensure payment, physicians submitting claims for Renessa® should follow federally approved guidelines and stay in accordance with the indications supported by peer-reviewed literature, which limits its use to moderate to severe SUI in women.

Providers submitting claims to FCSO should no longer use CPT® code 53899 Unlisted procedure, urinary system to report Renessa® treatments with dates of service on or after July 1.

LCDs are available through the CMS Medicare Coverage Database. Coding Guidelines for an LCD (when present) may be found by selecting “LCD Attachments” in the “Jump to Section,” drop-down menu at the top of the LCD page.

The Centers for Medicare & Medicaid Services (CMS) proposed, July 1, several policy and payment rate changes for hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) for fiscal year 2010. Payment rate increases for providers paid under the Outpatient Prospective Payment System (OPPS) and expanded coverage for certain Medicare services furnished in HOPDs and ASCs are projected in the 2010 proposed rule. Read more »

Wisconsin’s 60 ambulatory surgical centers (ASCs) may soon incur a tax that would raise state revenue $44 million over two years, Outpatient Surgery reports in its June 2 e-weekly newsletter.

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The Centers for Medicare & Medicaid Services (CMS) recently clarified when physicians and non-physician practioners (NPPs) may reassign benefits to ambulatory surgical centers (ASCs).

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The Centers for Medicare & Medicaid Services (CMS) will allow, in certain cases, an exception for patient notices required in advance of the day of a scheduled procedure, according to the Ambulatory Surgery Center (ASC) Association.

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