Coding ASC procedures to grow more complicated in 2008

Why This Topic Matters

The article matters because the new ASC payment system changes how facility claims are reported and paid, affecting reimbursement, service selection, and coding workflow for Medicare ASCs.

Article Sections

1. Overview of the new ASC payment system

   Introduces CMS’s new payment approach for ambulatory surgery centers and describes the general shift in reimbursement methodology. It frames the operational impact on ASC facility coding and payment patterns.

2. Scope of coverage and payment changes

   Summarizes the expected expansion in payable ASC procedures and the move to a broader payment structure. It also notes general payment-level changes and the role of procedure volume.

3. Office-based procedures

   Explains CMS’s treatment of procedures designated as office-based within the ASC setting. It discusses how this category affects payment classification and future designation status.

4. Transition to the new payment system

   Describes the multi-year implementation timeline CMS set for the ASC payment changes. It addresses how payments will phase in over time.

5. Conversion factor and ancillary services

   Covers the new conversion factor framework and the general categories of services that may receive additional payment. It also notes services that may be packaged into the procedure payment.

6. Excluded procedures and the FB modifier

   Summarizes procedures CMS excludes from ASC payment and references a modifier used for certain implantable items. It highlights the relationship between excluded services and payment adjustment.

7. Companion proposed rule and related policies

   Reviews related proposed changes, including policy adjustments affecting imaging services and selected procedures. It also notes broader administrative updates tied to the ASC system.