CODING & BILLING
3 4
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 4
85% more than ASCs for the same procedures. There is no health or
fiscal policy in place to justify this increasing inequity. The
Ambulatory Surgery Center Association (ASCA) fears this increasing
gap may discourage ASCs from participating in the Medicare program.
Additions to ASC payable list.
On the positive side, CMS pro-
poses to add 10 new spine procedures to the ASC list of
payable procedures for 2015.
Code Procedure
22551 Neck spine fuse & remove below C2
22554 Neck spine fusion
22612 Lumbar spine fusion
22614 Spine fusion extra segment
63020 Neck spine disk surgery
63030 Low back disk surgery
63042 Laminotomy single lumbar
63045 Removal of spinal lamina
63047 Removal of spinal lamina
63056 Decompress spinal cord
While these spine procedures have been done safely and effectively
in the ASC setting for years, the large disparity in payments between
HOPDs and ASCs may make it economically unfeasible for ASCs to
perform these procedures on Medicare beneficiaries. In addition,
there are still 349 codes that aren't payable in ASCs but are payable
when performed in HOPDs. ASCA will advocate movement to the
ASC payable list, particularly for those codes being performed in high
volumes in HOPDs.
