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CODING
&
BILLING
CMS could add 6 heart procedures to ASC-payable list
By Angie Stewart
C
MS proposed adding six coronary
intervention procedures — including
cardiac stenting — to the list of pay-
able 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 coro-
nary 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 an-
gioplasty when performed; single major
coronary artery or branch (CPT 92928)
• Percutaneous transcatheter placement
of intracoronary stent(s), with coronary
angioplasty when performed; each addi-
tional 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."
e additions were suggested on page 468 of
the 2020 Medicare Hospital Outpatient Pro-
spective Payment System and Ambulatory
Surgical Center Payment System Proposed
Rule, which CMS published July 29.
CMS is accepting public comments until
Sept. 27 on whether certain cardiovascular-
related surgical procedures should be cov-
ered beginning Jan. 1, 2020.
e agency is also soliciting public com-
ment on 13 additional coronary intervention
procedures, which it will consider adding to
the ASC covered list in "future rulemaking
cycles." ose procedures include percuta-
neous transluminal coronary atherectomy,
transluminal revascularization and trans-
catheter placement of drug-eluting intra-
coronary stents.
n
CVS to launch pilot program
for Aetna beneficiaries
undergoing total knee
replacement surgery
By Rachel Popa
C
VS plans to launch a pilot program this summer to
help Aetna knee replacement surgery patients with
care before and after their procedures, an Aetna
spokesperson confirmed to Becker's ASC Review.
The program aims to cut costs by decreasing hospital
readmission, the spokesperson said. The program was an-
nounced by CVS CEO Larry Merlo at the Medicare Advan-
tage conference in Washington, D.C. July 23, according to
a report from Healthcare Dive.
The coordinated care pilot will manage pre- and postop-
erative care for patients through CVS pharmacy locations,
an at-home clinical team and telehealth.
According to Healthcare Dive, a video shown at the confer-
ence depicted an Aetna beneficiary consulting a CVS case
manager to check whether her knee replacement surgeon
was in network and to schedule a postoperative assess-
ment. The patient in the video was also shown using the
CVS pharmacy to manage her prescriptions and buy a cane
to use after her operation.
CVS declined to disclose where the pilot would run.
n
ICD-11 is looming — 8 steps to
prepare
By Angie Stewart
T
he newest version of the International Classifica-
tion of Diseases, ICD-11, is set to take effect in
January 2022, according to Software Advice, a
business solutions company.
Software Advice created a timeline to help providers
prepare for the transition:
December 2019: Become familiar with the new ICD-11
chapters and codes.
January 2020: Communicate with revenue cycle man-
agement and EHR software representatives to ensure
the systems are up to date.
March 2020: Designate a point person to lead planning,
assessment and training ahead of the transition to ICD-11.
July 2020: Conduct an audit to determine current per-
formance regarding claim denials and coding accuracy.
October 2020: Create an action plan based on the self-
assessment results.
January 2021: Train staff on best practices for coding
and claim submission.
June 2021: Continue polishing coding and claims
processes.
January 2022: Begin reporting health data using ICD-11.
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