Update: Include 61795 in ASC Sinus Surgeries for 2008

Take note: You will not receive payment for stereotactic computer guidance in an ambulatory surgical center in 2008.
CMS had originally published a payment indictor of A2 (Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight) with +61795 (Stereotactic computer-assisted volumetric [navigational] procedure, intracranial, extracranial, or spinal [list separately in addition to code for primary procedure]). But the indicator was later revised to N1 (Packaged service/item; no separate payment made).
The final rule unconditionally packages 61795 into the payment for sinus surgical procedures, writes Debra Lansey, senior manager for socioeconomic affairs at the American Academy of Otolaryngology -- Head and Neck Surgery, in "2008 Medicare Payment Policy Updates" in the AAO-HNS Bulletin, January 2008. The academy opposed the payment indicator for two reasons:
1. surgeons don’t use guidance in every sinus surgery
2. bundling 61795 into sinus surgery reimbursement reduces payment for these sinus surgeries "because no additional reimbursement accompanies the bundling."
Don’t miss: You should refer to CMS 1392-FC for a list of current payment indicators (Addenda AA available at http://www.cms.hhs.gov/ASCPayment/04f_CMS-1392-FC(ASC).asp#TopOfPage.

- Published on 2008-03-14