Ambulatory Surgery – Also known as same-day surgery or outpatient surgery. Ambulatory surgery centers (ASC) are locations where surgeries can be performed without requiring admission to a hospital.
Procedures in Ambulatory Surgery
- Endoscopy/colonoscopy,
- Haemodialysis,
- Cataract surgery,
- Ear/Nose/Throat treatments,
- Gynecological procedures,
- Gall bladder removal,
- Kidney/bladder procedures,
- Arthroscopic/orthopedic procedures,
- Hernia procedures
Benefits of Ambulatory Surgery
- It is less costly. Outpatient surgical clinics benefit patients, insurers, and taxpayers alike because they are 45-60% less expensive than hospitals.
- Security.
- Convenience and accessibility are two of the most important factors to consider.
- Stress reduction.
- Scheduling is consistent.
Ambulatory Care
The Ambulatory Care Unit (ACU) is a new service that offers hospital patients same-day care. This means that patients are assessed, diagnosed, and treated on the same day and are able to go home without having to stay overnight in the hospital.
Examples of Ambulatory Care
Services provided in settings such as dialysis clinics, ambulatory surgical facilities, hospital outpatient departments, and the offices of physicians and other health professionals are examples of ambulatory care.
ASC Covered Procedure List Policy Revamped
As discussed in the 2022 OPPS/ASC final rule, CMS is reinstating the criteria for adding procedures to the ASC Covered Procedures List (ASC CPL) that were in place in CY 2020. After reviewing recommendations and comments on the 258 procedures proposed for removal from the ASC CPL, CMS decided to:
- Keep six procedures on the ASC CPL; three were already on the ASC CPL; three were proposed for removal (0499T, 54650, 60512).
- Remove 255 of the 258 procedures proposed for removal.
|
CPT® code |
Descriptor |
ASC PI |
| 0499T | Cystourethroscopy, with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis, including fluoroscopy, when performed | G2 |
| 54650 | Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) | G2 |
| 27412 | Autologous chondrocyte implantation, knee | J8 |
| +60512 | Parathyroid autotransplantation (List separately in addition to code for primary procedure) | N1* |
| 69660 | Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material | A2 |
| 28005 | Incision, bone cortex (eg, osteomyelitis or bone abscess), foot | A2 |
Surgical Procedures Finalized for Retention on the CY 2022 ASC CPL
NOTE: ASC PI=N1 is a packaged procedure and is not separately billed by ASCs
ASC Payment – Drugs and Biological
Effective Jan. 1, 2022, there are 11 new drug and biological HCPCS Level II codes; three are deleted (C9082, C9083, J2505).
| New HCPCS Code | Long Descriptor | Short Descriptor | SI |
| A9595 | Piflufolastat f-18, dianostic, 1 millicurie | Piflu f-18, dia 1 millicurie | K2 |
| C9085 | Injection, avalglucosidase alfa-ngpt, 4mg | Inj avalglucosid alfa-ngpt | K2 |
| C9086 | Injection, anifrolumab-fnia, 1mg | Inj, anifrolumab-fnia | K2 |
| C9087 | Injection, cyclophosphamide, (auromedics), 10 mg | Inj cyclophosphamd auromedic | K2 |
| C9088 | Instillation, bupivacaine and meloxicam, 1mg/0.03mg | Instill, bupivac and meloxic | K2 |
| C9089 | Bupivacaine, Collagen-matrix implant, 1mg | Bupivacaine implant, 1mg | K2 |
| J0172 | Injection, aducanumab-avwa, 2mg | Inj, aducanumab-avwa, 2mg | K2 |
| J2506 | Injection, pegfilgrastim, excludes biosimilar, 0.5 mg | Inj pegfilgrast ex bio 0.5mg | K2 |
| J9021 | Injection, asparaginase, recombinant, (rylaze), 0.1 mg | Inj, aspara, rylaze, 0.1 mg | K2 |
| J9061 | Injection, amivantamab-vmjw, 2mg | Inj, amivantamab-vmjw | K2 |
| J9272 | Injection, dostarlimab-gxly, 10 mg | Inj, dostarlimab-gxly, 10 mg | K2 |
New Code Highlights:
COVID-19
This year includes a new code to report sequela related to COVID-19, U09.9 (Post COVID-19 condition, unspecified). In addition, there were six codes introduced on January 1, 2021, related to COVID-19 that are included in this final list for FY 2022:
- J12.82 Pneumonia due to coronavirus disease 2019 (MCC)
- M35.81 Multisystem inflammatory syndrome (CC)
- M35.89 Other specified system involvement of connective tissue (CC)
- Z11.52 Encounter for screening for COVID-19
- Z20.822 Contact with and (suspected) exposure to COVID-19
- Z86.16 Personal history of COVID-19
In response to the ongoing national emergency concerning COVID-19, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing 3 new diagnosis codes, Z28.310, Z28.311 and Z28.39, into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting COVID-19 vaccination status effective April 1, 2022.
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