Health Information Management

Q/A: Proposed changes to the inpatient-only list

APCs Insider, July 27, 2012

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Q: Did CMS propose any changes to the inpatient-only list of procedures as part of the 2013 OPPS proposed rule?

A: CMS proposes removing these two procedures from the inpatient-only list:
  • CPT® code 22856, total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), single interspace, cervical
  • CPT code 27447, arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)
CMS recently announced it is changing the language in the Medicare Claims Processing Manual (Pub. 100-04) to indicate “inpatient only guidelines are being clarified to state that procedures removed from the ‘inpatient only’ list may be appropriately furnished in both the inpatient and outpatient settings and such procedures continue to be payable when furnished in the inpatient setting.”



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