decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 12 (December)
Good news for ophthalmology ASCs
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Article Overview
This article explains how the 2009 outpatient payment rule affects ophthalmology cases performed in ambulatory surgical centers and hospital outpatient departments. It is aimed at ophthalmologists, ASC owners, and coding/billing professionals who need a high-level view of which ophthalmic procedures were discussed in the payment update, which services were newly added to the ASC environment, and which implant-related procedures continue to face payment pressure. The article also places the discussion in the context of CMS payment policy and the broader ASC versus HOPD site-of-service landscape.
Why This Topic Matters
Understanding these payment updates helps ophthalmology practices and ASCs assess whether commonly performed procedures are financially feasible in the ASC setting and anticipate when cases may shift to the hospital outpatient department.
Article Sections
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ASC payment update for ophthalmology in 2009
Introduces the 2009 outpatient payment context and summarizes the overall ASC fee update discussed for ophthalmology. It frames the article around procedure mix and site-of-service considerations.
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Selected high-volume ophthalmic procedures and ASC fees
Lists a set of ophthalmic procedures with comparative ASC fee information across payment years. The section highlights changes in facility payment patterns for commonly performed services.
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New additions to the ASC list
Describes procedures newly added to the ASC covered list and related payment amounts. It also notes an additional procedure category discussed as device-intensive.
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Device-intensive and implant-related payment issues
Discusses how certain implant-dependent ophthalmic procedures are affected by ASC payment limitations. The section compares broader site-of-service incentives and references procedures involving drainage devices and other implants.
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Official resource
Provides a source link to the CMS fee schedule referenced in the article.
What You Will Learn
- How the 2009 ASC payment rule affected ophthalmology services
- Which broad categories of ophthalmic procedures were emphasized in the update
- Why some ophthalmic cases may be more financially practical in one site of service than another
- Which types of procedures were newly recognized in the ASC context
- How implant-related cases were discussed in relation to payment policy and site-of-service decisions
Who Should Read This
- Ophthalmologists
- Ambulatory surgical center administrators
- Medical coders
- Billing and reimbursement staff
- Practice managers
Codes Discussed
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