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ORX Awards and the Winners Are ... - September 2014 - 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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1 5 3 S E P T E M B E R 2 0 1 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 Yet payers don't reimburse robot-assisted surgery at a higher rate. At one time, plans covered robotic surgery with an add-on code, but that changed about 7 years ago, says Julie Kessel, MD, senior medical director for coverage policies at Cigna. "We decided that because the robotic approach was now a widely accepted standard in surgery, we would no longer consider separate reimbursement for it," she says. "We came to consider the robotic assist integral to the surgery itself," a determination she says is typical among commercial payers. Medicare employs a similar reimbursement policy: no premium for robotic assist, says Ms. Webb. Hospitals have an internal conflict when it comes to embracing same- day robot-assisted surgery. "Hospitals are incentivized to bill out the highest level of care while getting the patient out the door as quickly as possible," says Ms. Webb. For hospitals, the highest level of care includes an overnight admission. OSM Mr. Kirkner ( rmk irk ner@verizon.net ) is an independent healthcare journal- ist. Kendal Gapinski contributed to this report. U R O L O G Y

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