Otolaryngology Coding Alert

You cannot, unfortunately, report 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]). The indicator, however, was later revised to N1 (Packaged service/item; no separate payment made).

The example in "Evaluate Your Top Procedures in Light of the New Open-Door ASC System" in Otolaryngology Coding Alert (OCA) 2008, Vol. 10, No 2 should instead state that you cannot bill for stereotactic computer use in an ASC in 2008, as you could in 2007. Code 61795 is a packaged service.

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 AAO-HNS Bulletin January 2008. The Academy opposed the payment indicator for two reasons:

1. surgeons don't use imaging 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 use 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. The link in "Give Your ENTs the ASC Financial Information They Need" (OCA Vol. 10, No. 2) takes you to the earlier transmittal CMS-1517-F.