CMS could add 6 heart procedures to ASC-payable list

CMS proposed adding six coronary intervention procedures — including cardiac stenting — to the list of covered surgical procedures at ASCs in 2020.

Along with the much-anticipated proposal to add total knee arthroplasty to the ASC covered list, CMS' rule proposed adding a mosaicplasty procedure and these six coronary intervention procedures:

  • Percutaneous transluminal coronary angioplasty; single major coronary artery or branch (CPT 92920)
  • Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (CPT 92921)
  • Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch (CPT 92928)
  • Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (CPT 92929)
  • Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch (CPT C9600)
  • Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (CPT C9601)

CMS said the three coronary intervention procedures involving major blood vessels "can be safely performed in an ASC setting and would not pose a significant safety risk to beneficiaries if performed in an ASC setting."

The additions were suggested on page 468 of the 2020 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule, which CMS published on July 29.

CMS is accepting public comments until Sept. 27 on whether certain cardiovascular-related surgical procedures should be covered beginning Jan. 1, 2020.

The agency is also soliciting public comment on 13 additional coronary intervention procedures, which it will consider adding to the ASC covered list in "future rulemaking cycles." Those procedures include percutaneous transluminal coronary atherectomy, transluminal revascularization and transcatheter placement of drug-eluting intracoronary stents.

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