Free e-Newsletters

Ambulatory Surgery Reimbursement Update

Ambulatory Surgery Regulation Update is a weekly e-mail newsletter that offers news and stories about regulatory issues in ambulatory surgery, like certificate of need legislation and physician ownership issues, presented in a "quick-read" format. You'll also receive links to industry reports as available.

2008 | 2007 | 2006 | 2005 | 2004

Ambulatory Surgery Reimbursement Update

Issue 50, December 16, 2008

• ASCs in the news: Outpatient center surgeries increase in California's Bay area

  ASCs in the news: Outpatient center surgeries increase in California's Bay area

• Tip: Understand the 2009 prostate procedure changes

  Tip: Understand the 2009 prostate procedure changes

• Topic: Examine reimbursement for refills

  Topic: Examine reimbursement for refills

• Notice: This is the last issue of Ambulatory Surgery Reimbursement Update

  Notice: This is the last issue of Ambulatory Surgery Reimbursement Update

Issue 49, December 9, 2008

• ASCs in the news: Pennsylvania ASCs see increased volume and profits

  ASCs in the news: Pennsylvania ASCs see increased volume and profits  

• Tip: Master the pain management injection procedures newly covered by Medicare

  Tip: Master the pain management injection procedures newly covered by Medicare

• Topic: Note billing changes for infusion pumps

  Topic: Note billing changes for infusion pumps

• Notice: This is the next to last issue of Ambulatory Surgery Reimbursement Update

  Notice: This is the next to last issue of Ambulatory Surgery Reimbursement Update

Issue 48, December 2, 2008

• ASCs in the news: CMS grants continued recognition to two ASC accreditors

  Normal 0 false false false MicrosoftInternetExplorer4...

• Tip: Know the new laparoscopic hernia repair procedures

  Tip: Know the new laparoscopic hernia repair procedures

• Topic: Negotiate device payment into contracts

  Topic: Negotiate device payment into contracts

• Topic: Note billing changes for infusion pumps

  Topic: Note billing changes for infusion pumps

Issue 47, November 25, 2008

• ASCs in the news: Massachusetts makes it harder to build new ASCs, clinics

  ASCs in the news: Massachusetts makes it harder to build new ASCs, clinics

• Tip: Understand the Medicare coverage changes for hemorrhoid procedures

  Tip: Understand the Medicare coverage changes for hemorrhoid procedures

• Topic: Billing rules for devices can be different for each payer

  Topic: Billing rules for devices can be different for each payer

Issue 46, November 18, 2008

• ASCs in the news: CMS releases ASC payment schedules for fourth quarter 2008 and 2009; ASC Association makes CMS rule details accessible

  ASCs in the news: CMS releases ASC payment schedules for fourth quarter 2008 and 2009; ASC...

• Tip: Say goodbye to Medicare payments for IDETs

  Tip: Say goodbye to Medicare payments for IDETs

• Topic: Understand the billing methods for different types of lenses

  Topic: Understand the billing methods for different types of lenses

Issue 45, November 11, 2008

• ASCs in the news: 2009 OPPS/ASC final rule has mixed results for ASCs

  ASCs in the news: 2009 OPPS/ASC final rule has mixed results for ASCs

• Tip: Learn the laparoscopic total hysterectomy procedure codes

  Tip: Learn the laparoscopic total hysterectomy procedure codes

• Topic: Be a G whiz: Understand when to assign G codes, new codes (part two)

  Topic: Be a G whiz: Understand when to assign G codes, new codes (part two)

Issue 44, November 4, 2008

• ASCs in the news: New York fines ASCs for overcharging state insurance program

  ASCs in the news: New York fines ASCs for overcharging state insurance program

• Tip: Manage laparoscopic cholecystectomy procedure billing

  Tip: Manage laparoscopic cholecystectomy procedure billing

• Topic: Be a G whiz: Understand when to assign G codes (part one)

  Topic: Be a G whiz: Understand when to assign G codes (part one)

Issue 43, October 28, 2008

• ASCs in the news: Members of Congress express concerns to CMS about ASC payments

  ASCs in the news: Members of Congress express concerns to CMS about ASC payments

• Tip: Handle bariatric surgery coding

  Tip: Handle bariatric surgery coding

• Topic: Develop strong billing strategies

  Topic: Develop strong billing strategies

Issue 42, October 21, 2008

• ASCs in the news: CMS names RAC contractors

  ASCs in the news: CMS names RAC contractors

• Tip: Understand sentinel nodes

  Tip: Understand sentinel nodes

• Topic: Analyze implant costs carefully

  Topic: Analyze implant costs carefully

Issue 41, October 14, 2008

• ASCs in the news: Something old, something new for ASCs in the OIG 2009 work plan

  ASCs in the news: Something old, something new for ASCs in the OIG 2009 work plan

• Tip: Correctly code ear and auditory procedures

  Tip: Correctly code ear and auditory procedures

• Topic: Try to boost staff efficiency

  Topic: Try to boost staff efficiency

Issue 40, October 7, 2008

• ASCs in the news: Firm announces new mobile brachytherapy service for ASCs

  ASCs in the news: Firm announces new mobile brachytherapy service for ASCs

• Tip: Create insurance cheat sheets

  Tip: Create insurance cheat sheets  

• Topic: Operational challenges: Bringing down high energy costs

  Topic: Operational challenges: Bringing down high energy costs

Issue 39, September 30, 2008

• ASCs in the news: ASC Association criticizes CMS on low payment rates for 2009

    Normal 0 false false false MicrosoftInternetExplorer4...

• Tip: Review EOBs

  Tip: Review EOBs    

• Topic: six critical elements of a complete payment policy

  Topic: six critical elements of a complete payment policy

Issue 38, September 23, 2008

• ASCs in the news: CMS discusses ASC requirements for physician names and NPIs on claims for diagnostic services

  ASCs in the news: CMS discusses ASC requirements for physician names and NPIs on claims for...

• Tip: Verify patient financial responsibility

  Tip: Verify patient financial responsibility

• Tip: Verify patient financial responsibility

  Tip: Verify patient financial responsibility

• Topic: Take note of global period for podiatry procedures

   Topic: Take note of global period for podiatry procedures

Issue 37, September 16, 2008

• ASCs in the news: Creative events mark National ASC Open House Day

  ASCs in the news: Creative events mark National ASC Open House Day  

• Tip: Manage colonoscopy procedure scheduling and benefit verifications

  Tip: Manage colonoscopy procedure scheduling and benefit verifications

• Topic: Know the criteria for applying modifier -59 to podiatry codes

  Normal 0 false false false MicrosoftInternetExplorer4...

• Topic: Know the criteria for applying modifier -59 to podiatry codes

  Topic: Know the criteria for applying modifier -59 to podiatry codes  

• Topic: Know the criteria for applying modifier -59 to podiatry codes

  Topic: Know the criteria for applying modifier -59 to podiatry codes  

Issue 36, September 9, 2008

• ASCs in the news: California ASCs slowly working through no-license tangle

  ASCs in the news: California ASCs slowly working through no-license tangle

• Tip: Justify medical necessity on your claims

  Tip: Justify medical necessity on your claims

• Topic: Review modifier -59 and T modifiers used for podiatry coding

  Topic: Review modifier -59 and T modifiers used for podiatry coding

Issue 35, September 2, 2008

• ASCs in the news: Competition closes doors of oldest Washington surgery center

  ASCs in the news: Competition closes doors of oldest Washington surgery center

• Tip: Accident cases

  Tip: Accident cases

• Topic: Dos and don'ts for out-of-network billing

  Topic: Dos and don’ts for out-of-network billing

Issue 34, August 26, 2008

• ASCs in the news: HHS announces timeline for transition to ICD-10-CM

  ASCs in the news: HHS announces timeline for transition to ICD-10-CM

• Tip: Obtain precertifications as necessary

  Tip: Obtain precertifications as necessary

• Topic: Learn the four catheterization codes, part two

  Topic: Learn the four catheterization codes, part two

Issue 33, August 19, 2008

• ASCs in the news: OIG opinion declines to penalize ASC joint ownership by surgeons and hospital

  ASCs in the news: OIG opinion declines to penalize ASC joint ownership by surgeons and hospital

• Tip: Always verify insurance ahead of time

  Tip: Always verify insurance ahead of time

• Topic: Learn to use all the catheterization codes, part 1

  Topic: Learn to use all the catheterization codes, part 1

• Editor's note: Last chance! ASC Nurses, we need your help!

  Editor’s note: Last chance! ASC Nurses, we need your help!

Issue 32, August 12, 2008

• ASCs in the news: Ohio ASCs and hospitals vie for patients as demographics shift

  ASCs in the news: Ohio ASCs and hospitals vie for patients as demographics shift

• Tip: Avoid medical necessity denials

  Tip: Avoid medical necessity denials

• Topic: Don't make assumptions based on NCCI edits

  Topic: Don’t make assumptions based on NCCI edits

• Topic: Make no assumptions based on NCCI edits

  Topic: Make no assumptions based on NCCI edits

Issue 31, August 5, 2008

• ASCs in the news: PA ASC uses online pre-assessment to reduce procedure cancellations

  ASCs in the news: PA ASC uses online pre-assessment to reduce procedure cancellations

• Tip: Avoid upcoding or undercoding procedures

  Tip: Avoid upcoding or undercoding procedures

• Topic: Review commonly misused urology codes

  Topic: Review commonly misused urology codes

• Editor's note: ASC Nurses, we need your help!

  Editor’s note: ASC Nurses, we need your help!

Issue 30, July 29, 2008

• ASCs in the News: California ASC in impasse with Anthem Blue Cross

  ASCs in the News: California ASC in impasse with Anthem Blue Cross

• Tip: Deal with denials for 'medical necessity' reasons

  Tip: Deal with denials for ‘medical necessity’ reasons

• Topic: Changes for pain control injections

  Topic: Changes for pain control injections

• Editor's note: ASC Nurses, we need your help!

  Editor’s note: ASC Nurses, we need your help!

Issue 29, July 22, 2008

• ASCs in the news: Mixed reviews for ASC proposed rule from two organizations

  ASCs in the news: Mixed reviews for ASC proposed rule from two organizations

• Tip: Correctly code clavicle procedures (7/22)

  Tip: Correctly code clavicle procedures (7/22)

• Topic: Review nerve destruction codes

  Topic: Review nerve destruction codes

Issue 28, July 15, 2008

• ASCs in the news: Two more indicted in California medical insurance fraud

  ASCs in the news: Two more indicted in California medical insurance fraud

• Tip: Understand the procedures that treat plantar fasciitis

  Tip: Understand the procedures that treat plantar fasciitis

• Topic: Guidance explains continuous infusion

  Topic: Guidance explains continuous infusion

Issue 27, July 8, 2008

• ASCs in the news: CMS releases 2009 ASC proposed rule: ASC payments still changing

  ASCs in the news: CMS releases 2009 ASC proposed rule: ASC payments still changing

• Tip: Know the common bunionectomy procedure codes and how to use them

  Tip: Know the common bunionectomy procedure codes and how to use them

• Topic: More pain drugs payable to ASCs

  Topic: More pain drugs payable to ASCs

Issue 26, July 1, 2008

• ASCs in the news: EHR systems still rare among ambulatory physicians

  ASCs in the news: EHR systems still rare among ambulatory physicians

• Tip: Carefully code fracture care

  Tip: Carefully code fracture care

• Topic: CMS adds four separately payable drugs, deletes two other drug codes from list

  Topic: CMS adds four separately payable drugs, deletes two other drug codes from list

Issue 25, June 24, 2008

• ASCs in the news: The Joint Commission's 2009 patient safety goals include new requirements for ASCs

  ASCs in the news: The Joint Commission’s 2009 patient safety goals include new requirements...

• Tip: Identify covered nerve block procedures

  Tip: Identify covered nerve block procedures

• Topic: Urge physicians to note necessary details to ensure proper coding

  Topic: Urge physicians to note necessary details to ensure proper coding

• Topic: Urge physicians to note necessary details to ensure proper coding

  Topic: Urge physicians to note necessary details to ensure proper coding

Issue 24, June 17, 2008

• ASCs in the news: ASC Association says payment legislation needs your help

  ASCs in the news: ASC Association says payment legislation needs your help

• ASCs in the news: ASC Association says payment legislation needs your help

  ASCs in the news: ASC Association says payment legislation needs your help

• Tip: Bill for bilateral procedures

  Tip: Bill for bilateral procedures

• Topic: Study the codes for new orthopedics procedures

  Topic: Study the codes for new orthopedics procedures

Issue 23, June 10, 2008

• ASCs in the news: California agency stops licensing physician-owned ASCs

  ASCs in the news: California agency stops licensing physician-owned ASCs

• ASCs in the news: California agency stops licensing physician-owned ASCs

  ASCs in the news: California agency stops licensing physician-owned ASCs

• Tip: Understand implants, devices related to spinal neurostimulator procedures

  Tip: Understand implants, devices related to spinal neurostimulator procedures

• Topic: Evaluate inclusion of new orthopedic procedures

  Topic: Evaluate inclusion of new orthopedic procedures

Issue 22, June 3, 2008

• ASCs in the news: California seeks tighter outpatient cosmetic surgery oversight

  ASCs in the news: California seeks tighter outpatient cosmetic surgery oversight

• Tip: Lipoma removals

  Tip: Lipoma removals

• Topic: Steps to securing appropriate orthopedic reimbursement

  Topic: Steps to securing appropriate orthopedic reimbursement

Issue 21, May 27, 2008

• ASCs in the news: ASCs forecast to perform more urology and gynecology procedures

  ASCs in the news: ASCs forecast to perform more urology and gynecology procedures

• Tip: Understand breast capsule procedures

  Tip: Understand breast capsule procedures

• Topic: Improve coding ophthalmology at your ASC (part three)

  Topic: Improve coding ophthalmology at your ASC (part three)

Issue 20, May 20, 2008

• ASCs in the news: Vermont's first ASC opens after lengthy approval process

  ASCs in the news: Vermont’s first ASC opens after lengthy approval process

• Tip: Correctly code from op reports

  Tip: Correctly code from op reports

• Topic: Improve coding ophthalmology at your ASC (part two)

  Topic: Improve coding ophthalmology at your ASC (part two)

Issue 19, May 13, 2008

• Tip: Avoid 'canned' op reports

  Tip: Avoid ‘canned’ op reports

• Topic: Improve ophthalmology coding at your ASC (part one of two)

  Topic: Improve ophthalmology coding at your ASC (part one of two)

• ASCs in the news: Texas ASC top denial, reject reasons for first quarter 2008 announced

  ASCs in the news: Texas ASC top denial, reject reasons for first quarter 2008 announced

• Editor's note: Complete your 2008 ASCRI administrator salary survey by May 14

  Editor’s note: Complete your 2008 ASCRI administrator salary survey by May 14

• Editor's note: Complete your 2008 ASCRI administrator salary survey by May 14

  Editor’s note: Complete your 2008 ASCRI administrator salary survey by May 14

Issue 18, May 6, 2008

• Tip: Understand PEG tubes

  Tip: Understand PEG tubes

• Topic: Watch out for multiple kyphoplasty codes

  Topic: Watch out for multiple kyphoplasty codes

• ASCs in the news: Study indicates reimbursement concerns affect EHR adoption for ASCs

  ASCs in the news: Study indicates reimbursement concerns affect EHR adoption for ASCs

• Editor's note: Don't miss the 2008 ASCRI administrator salary survey (*updated*)

  Editor’s note: Don’t miss the 2008 ASCRI administrator salary survey (*updated*)

Issue 17, April 28, 2008

• Tip: Understand the surgical treatment of a dislocating patella

  Tip: Understand the surgical treatment of a dislocating patella

• Topic: Carefully code facial fractures

  Topic: Carefully code facial fractures

• ASCs in the news: ASC Association responds to proposed Medicare ASC payment cuts

  ASCs in the news: ASC Association responds to proposed Medicare ASC payment cuts

• Editor's note: Don't miss the 2008 ASCRI administrator salary survey

  Editor’s note: Don’t miss the 2008 ASCRI administrator salary survey

Issue 16, April 21, 2008

• Tip: Understand ICD-9-CM procedure codes

  Tip: Understand ICD-9-CM procedure codes

• Topic: Correctly code general surgery for lesion removal

  Topic: Correctly code general surgery for lesion removal

• ASCs in the news: CMS Issues April 2008 Update to the ASC Payment System

  ASCs in the news: CMS issues April 2008 update to the ASC payment system

• Editor's note: Don't miss the 2008 ASCRI administrator salary survey

  Editor’s note: Don’t miss the 2008 ASCRI administrator salary survey

• Editor's note: Don't miss the 2008 ASCRI administrator salary survey

  Editor’s note: Don’t miss the 2008 ASCRI administrator salary survey

Issue 15, April 15, 2008

• ASCs in the news: ASC Association to hold annual meeting

  ASCs in the news: ASC Association to hold annual meeting

• Topic: CMS issues four new payable drug codes

  Topic: CMS issues four new payable drug codes

• Tip: Correctly code synovitis

  Tip: Correctly code synovitis

Issue 14, April 8, 2008

• ASCs in the News: NJ ASCs form association, fight legislation limiting self-referrals

  ASCs in the News: NJ ASCs form association, fight legislation limiting self-referrals

• Topic: Break the chain of common coding errors for ENT procedures, part 2

  Topic: Break the chain of common coding errors for ENT procedures, part 2

• Tip: Understand revenue codes

  Tip: Understand revenue codes

Issue 13, April 1, 2008

• ASCs in the news: Pennsylvania physician-referral study disputed

  ASCs in the news: Pennsylvanis physician-referral study disputed

• ASCs in the news: Pennsylvania physician-referral study disputed

  ASCs in the news: Pennsylvania physician-referral study disputed

• Topic: Break the chain of common coding errors for ENT procedures, part 1

  Topic: Break the chain of common coding errors for ENT procedures, part 1

• Tip: Know your T&A procedures

  Tip: Know your T&A procedures

Issue 12, March 25, 2008

• HCPro, Inc. launches new logo and tagline as part of its new corporate branding initiative

  HCPro, Inc. launches new logo and tagline as part of its new corporate branding initiative

• Tip: New 2008 code for the osteochondral autograft ankle procedure

  Tip: New 2008 code for the osteochondral autograft ankle procedure

• ASCs in the news: Study finds physician-owners of ASCs refer more privately-insured patients to surgery centers

  ASCs in the news: Study finds physician-owners of ASCs refer more privately-insured patients to...

• Topic: Avoid coding mistakes for orthopedic procedures

  Topic: Avoid coding mistakes for orthopedic procedures

Issue 11, March 18, 2008

• Tip: Report new 2008 code for fracture treatment of the tibia, fibula, and ankle

  Tip: Report new 2008 code for fracture treatment of the tibia, fibula, and ankle

• Tip: Report new 2008 code for fracture treatment of the tibia, fibula, and ankle

  Tip: Report new 2008 code for fracture treatment of the tibia, fibula, and ankle

• Topic: Break the chain of common coding errors-Avoid gastroenterology coding mistakes

  Topic: Break the chain of common coding errors-Avoid gastroenterology coding mistakes

• ASCs in the news: CMS to modify medically unlikely edit (MUE) for CPT code 90766 in April

  ASCs in the news: CMS to modify medically unlikely edit (MUE) for CPT code 90766 in April

Issue 10, March 11, 2008

• Tip: Correctly report new 2008 CPT procedure code for soft tissue cancer brachytherapy

  Tip: Correctly report new 2008 CPT procedure code for soft tissue cancer brachytherapy

• Topic: Common coding mistakes by specialty-Avoid errors in pain management and lesion removal

  Topic: Common coding mistakes by specialty-Avoid errors in pain management

• Topic: Common coding mistakes by specialty-Avoid errors in pain management

  Topic: Common coding mistakes by specialty-Avoid errors in pain management

• News: Humana cuts ASCs from network, patient costs to rise

  ASCs in the news: Humana cuts ASCs from network, patient costs to rise

Issue 9, March 4, 2008

• Report new 2008 CPT codes for hip and pelvis fractures and dislocations

  Report new 2008 CPT codes for hip and pelvis fractures and dislocations

• 2008 ASC Employee Salary & Benefits Survey to collect data on salary, staffing, and more

  2008 ASC Employee Salary & Benefits Survey to collect data on salary, staffing, and more

• Utah bill seeks state Medicaid program reimbursement for ASCs

  Utah bill seeks state Medicaid program reimbursement for ASCs

Issue 8, February 26, 2008

• Coding tip: Examine the new 2008 CPT code for osteochondral autograft knee procedures

  Coding tip: Examine the new 2008 CPT code for osteochondral autograft knee procedures

• Newly-approved reimbursement raises ASC's interest in prostate cancer brachytherapy programs

  Newly-approved reimbursement raises ASC's interest in prostate cancer brachytherapy programs

• Survey reveals findings on ASC valuation

  Survey reveals findings on ASC valuation

Issue 7, February 19, 2008

• ASCA announces National ASC Open House Day

  ASCA announces National ASC Open House Day

• Coding tip: Consider three new 2008 add-on codes for computer-assisted navigation for musculoskeletal procedures

  Coding tip: Consider three new 2008 add-on codes for computer-assisted navigation for...

• WASCA agrees not to bill for medical errors

  WASCA agrees not to bill for medical errors

Issue 6, February 12, 2008

• UnitedHealth Group faces $1.3 billion fine in California

  UnitedHealth Group faces $1.3 billion fine in California

• Coding tip: Learn the new 2008 CPT codes for elbow procedures-Big changes for epicondylitis

  Coding tip: Learn the new 2008 CPT codes for elbow procedures-Big changes for epicondylitis

• St. Vincent's ASC continues fighting for CON

  St. Vincent's ASC continues fighting for CON

• Don't miss the 2008 ASCRI A/R Salary Survey

  Don't miss the 2008 ASCRI A/R Salary Survey

Issue 5, February 5, 2008

• Don't miss the 2008 ASCRI A/R Salary Survey

  Dear Accounts Receivable (A/R) staff members, We need your help. HCPro wants to be sure we provide...

• Coding tip: Discover the new 2008 arthroscopic code for the shoulder biceps tenodesis

  The American Medical Association issued a new arthroscopic code for a biceps tenodesis for 2008...

• Codey legislation still lingers

  Since 1991, Richard J. Codey's law has prohibited physician referrals to facilities in which they...

• Circulating Nurse Act may change ASC requirements

  The Pennsylvania House scheduled to vote on Pennsylvania House Bill 1867, better known as the...

Issue 4, January 29, 2008

• Don't miss the 2008 ASCRI A/R Salary Survey

  Dear Accounts Receivable (A/R) staff members, We need your help. HCPro wants to be sure we provide...

• Coding tip: Examine the 2008 CPT changes to orthopedic fracture treatment: Note the major revisions to fracture care verbiage

  If your ASC performs fracture care, you will want to be aware of the new CPT language for many 2008...

• Massachusetts Senate bill may create stricter ASC rules

  In 2007, the Massachusetts state Senate did not pass Bill 1318, which would have created licensure...

Issue 3, January 22, 2008

• Aetna to discontinue payment of monitored anesthesia care for routine colonoscopies

  As of April 1, Aetna intends to halt payment for monitored anesthesia care for routine...

• Coding tip: Learn the difference between nasopharyngoscopy and endoscopy procedures

  When the surgeon uses an endoscope to view only the nasopharynx, it is a nasopharyngoscopy...

• Web site offers analytical report on ASCs, reimbursement

  ResearchandMarkets.com now offers a report titled "Global Trends in Reimbursement of Medical...

• CMS posts FAQ containing ASC questions

  CMS posted new ASC Q&As on its FAQ forum January 7.

Issue 2, January 15, 2008

• Study measures quality differences between ASCs and hospital outpatient departments

  A study titled "Comparative Study of Quality Outcomes in Freestanding Ambulatory Surgery Centers...

• Coding tip: Code the appropriate endoscopy of each anatomic site examined in the same session for ENT endoscopy procedures

  You often hear physicians refer to ear, nose, and throat (ENT) endoscopy procedures as Functional...

• OIG posts Solicitation of New Safe Harbors and Special Fraud Alerts

  The Office of Inspector General (OIG) posted its annual Solicitation of New Safe Harbors and...

Issue 1, January 8, 2008

• Battle over Georgia's CON rule flares up once more

  The Georgia Alliance of Community Hospitals filed a lawsuit December 31, 2007 to overturn a new...

• Coding tip: Know how to correctly code each procedure an otolaryngologist can perform on turbinates

  Procedures that otolaryngologists can perform on the turbinates include the following...

• Orthopedic surgeons, HealthSouth pay $14.9 million for false claims

  Orthopedic surgeons James Andrews, MD, and Lawrence Lemak, MD, along with the Birmingham, AL-based...