What ASC anesthesia groups should know about the 2019 final payment rule: 6 insights

Anesthesia practices should prepare to see procedure mix changes at ASCs beginning in 2019 because of CMS' final payment rule, according to Anesthesia Business Consultants President and CEO Tony Mira.

Here are six insights:

1. CMS published the Outpatient Prospective Payment System and ASC Payment System Final Rule, which adds 12 cardiac catheterization procedures and five additional cardiology procedures to the list of covered ASC procedures.

2. The final rule also changes the definition of surgery in ASCs to include certain "surgery-like" procedures with codes outside the CPT surgical range.

3. These modifications could expand the types of procedures performed in ASCs, and facilities should prepare to handle the new types of cases.

4. CMS also decided to remove CPT Code 01402 (anesthesia for open or surgical arthroscopic procedures on knee joint; total joint arthroplasty) from the inpatient-only list. However, the removal of a procedure from the list doesn't require providers to perform those cases on an outpatient basis.

5. In addition, CMS will finalize its proposal to pay separately for non-opioid pain management drugs functioning as a supply for ASCs.

6. The agency will remove the three recently revised pain communication questions from the Hospital Consumer Assessment of Healthcare Providers and System while continuing to examine the value of collecting data related to pain management.

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