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REGULATORY REVIEW


■ 58573 (Tlh w/t/o uterus over 250) ■ 63046 (Remove spine lamina 1 thr) ■


63055 (Decompress spinal cord thc) ASCA advocated for these codes and others to be added. Unfortunately, in the final rule, 336 codes that are payable when they are performed in HOPDs are still not designated as pay- able in the ASC setting. ASCA will continue to encourage CMS to move these procedures to the ASC payable list, particularly focusing on those codes being performed in high vol- umes in HOPDs, an indicator that they are safe to be performed on the Medi- care population in outpatient settings.


Device-Intensive


CMS also maintained the device-inten- sive policy change it implemented in 2015. That means CMS continues to define ASC device-intensive procedures as those that are assigned to any ambula- tory payment classification (APC) group with a device cost greater than 40 per- cent of the total cost of the procedure in the HOPD setting. The previous thresh- old was 50 percent, and ASCA has long advocated for the threshold to be low- ered, preferably to 30 percent. ASCA once again recommended that CMS drop the threshold percent down to 30 percent, allowing for more procedures to migrate to the lower-cost ASC setting. CMS finalized its proposal to continue its device-intensive procedure policy. CMS acknowledged ASCA’s recommendation that the agency lower the threshold per- cent to 30 percent and noted that it would consider the feedback as well as feed- back from other stakeholders for future rule-making.


Unlisted Codes Unfortunately, CMS is continuing its pol- icy to not reimburse ASCs for unlisted codes because it believes that it is not “appropriate to provide ASC payment for procedures described by unlisted CPT codes in the surgical range, even if payment may be provided under the


OPPS.” There are currently 62 unlisted codes that are kept off of the ASC-pay- able list solely because they are unlisted codes. Commercial payers commonly allow ASCs to use unlisted CPT codes to report procedures, and CMS permits this practice for HOPDs but not for ASCs. ASCA will continue to work with CMS to try to get this policy reversed.


Quality Reporting for ASCs Based on feedback submitted in the com- ment period, CMS did not finalize its proposal to align the reporting deadline for all web-based measures in the ASC Quality Reporting Program beginning next year. CMS will maintain the August 15 submission deadline for data submit- ted via QualityNet, the CMS web-based tool. However, it noted that the May 15, 2016, deadline was not changed for ASC-8. This information is submitted via the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN) web site.


CMS did not add any new mea- sures to the ASC Quality Reporting Program for 2016. It did, however, ask for feedback on two measures for future consideration: Normother- mia and Unplanned Anterior Vitrec- tomy. CMS noted in its final rule that the Normothermia Outcome measure was supported by stakeholders, but one commenter noted that there is no evidence of a performance gap in hypothermia for ASC providers. With respect to Unplanned Anterior Vitrec- tomy, the majority of comments sup- ported inclusion. In the end, CMS did not finalize the inclusion of these mea- sures; rather, it noted that it would take the comments and recommendations it received on these two measures into consideration if it chooses to move forward with them.


Kara Newbury is ASCA’s regulatory counsel. Write her at knewbury@ascassociation.org.


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ASC FOCUS FEBRUARY 2016


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