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Fair and Equal Pay? - January 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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includes all colonoscopy procedures coded 45378 through 45398, though colonoscopy with a stent (45389) and colonoscopy using ultra- sound-guided fine needle aspiration (45392) will see big jumps in reimbursement this year. One of the biggest drops includes proctoplasty procedures (45500 and 45505), which will drop 12.7% or an average decrease of $130. And while the sigmoidoscopy family saw a few increases, most of the codes in the category — including 45337, 45388, 45340, 45341, 45346, 45349 and 45390 — were cut about 7%, an average of $32 less per pro- cedure. While there are some increases this year, especially in upper endo- scopic procedures, for the most part you'll be seeing cuts in reim- bursement for your most common GI services. And while most of the drops are slight, you still may want to focus on minimizing costs and looking for additional opportunities to make up any missed revenue. Focus on increasing efficiency while ensuring that patient safety is still the No.1 priority. Improperly reprocessed flexible endoscopes continue to be a problem that can have devastating financial conse- quences, and one that has even shut down centers. A good way to make up for the drop in revenue is to try to attract patients who aren't Medicare beneficiaries. Since screening colono- scopies starting at age 50 is the standard for preventative care, there are still plenty of patients with commercial insurance plans. Negotiate con- tracts with the big insurers in your area, if you haven't already. Additionally, before scheduling any colonoscopy, make sure that you verify the patient's insurance and confirm with the referring physician's office whether the procedure is a diagnostic colonoscopy or a screening one. (A reminder: Screening tests are given in the absence of signs or symptoms, while diagnostic ones are tests per- J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 2 7

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