there is no
associated
claims data,
CMS is pro-
posing to
apply device-
intensive status with a default device offset set at 41% until claims data
are available to establish the HCPCS code-level device offset for the
procedures. While the device offset percentage was not dropped to
30% as previously requested, the change from APC-level to HCPCS
code-level determination would likely increase the number of codes
defined as device intensive. If finalized, this is a win for ASCA.
Additions to ASC list. CMS is proposing to add 8 add-on codes
(therefore not separately payable) to existing spine procedures
on the ASC list: 20936-20938, 22552, 22840, 22842, 22845 and 22851.
CMS is proposing to remove 3 other codes from the inpatient-only list:
22858 (cervical arthroplasty) and larynx repair codes 31584 and 31587.
CMS says it won't add these procedures to the ASC list because they
"would generally be expected to require at least an overnight stay."
Quality reporting. CMS wants to add 7 measures for 2020 (none
for 2019) payment determinations and beyond: normothermia
outcome, unplanned anterior vitrectomy and 5 measures from the
Outpatient and Ambulatory Surgery Survey Consumer Assessment of
Healthcare Providers and Systems (OAS CAHPS). The survey meas-
ures patient experiences with their surgeries. CMS is also requesting
input on a measure for future consideration: the Toxic Anterior
Segment Syndrome (TASS) measure.
7
6
M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 2 9
Let Your Voice Be Heard
These proposals could change. Go to osmag.net/jfXVA6
to view and to comment on Medicare's proposed Outpatient
Prospective Payment System rules until Sept. 6, 2016.
The final rules should arrive in early November.
