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OIG plans to review ASC procedures, policies for 2008

Ambulatory Surgery Reimbursement Update, October 30, 2007

The Department of Health and Human Services' (HHS) Office of Inspector General (OIG) released its 2008 Work Plan October 1, which detailed a plan to review ambulatory surgery centers (ASCs) coding policies and procedures, according to the Work Plan.

The Plan states, "We [the OIG] will review physician coding of place of service on claims for services performed in ambulatory surgical centers (ASCs) and hospital outpatient departments . . . Medicare pays a physician a higher amount when a service is performed in a non-facility setting, such as a physician's office, than it does when the service is performed in a hospital outpatient department or, with certain exceptions, in an ASC. We will determine whether physicians properly coded the places of service on claims for services provided in ASCs and hospital outpatient departments."

According to the American Association for Ambulatory Surgery Centers (AAASC), the OIG hopes to review ASC payment system changes, as well as the methodology used to calculate the new ASC payment rates.

To view the OIG's Work Plan, click here.

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