Becker's Spine Review

Becker's January 2023 Spine Review

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32 ASC CMS adds 4 new ASC covered procedures By Claire Wallace C MS released its 2023 payment and procedure updates for ASCs and hospital outpatient departments, finalizing an update of 3.8 percent. CMS also added four new procedures to the list of covered ASC procedures, according to a Nov. 1 report from the Ambulatory Surgery Center Association. Although the association proposed several new procedures, only four were finalized. The four procedures are: 19307, mast mod rad; 37193, rem endovas vena cava filter; 38531, open bx/exc inguinofem nodes; and 43774, lap rmvl gastr adj all parts. n Why the No Surprises Act is harming anesthesiologists By Patsy Newitt T he No Surprises Act has created financial challenges for anesthesiologists, the American Society of Anesthesiologists said Nov. 15. e implementation of the law has harmed physicians specifically at small and medium-sized practices, the society said in a news release. Insurance companies have slashed payments for anesthesiologists by nearly 40 percent in many cases. e ASA proposed a number of changes to the implementation of the No Surprises Act in a Nov. 14 letter to CMS' Center for Consumer Information and Insurance Oversight. Here are three of the changes anesthesiologists are proposing: 1. Audit payer qualifying payment amounts According to the release, there have been ongoing reports of payers using inaccurate qualifying payment amounts, including many unreasonably low rates inconsistent with local in-network contract rates. ASA proposes CMS implement audits of payer QPAs. 2. Li resolution dispute holds ere have been numerous reports of independent dispute resolution holds on anesthesia claims, some in place for 90 days or longer, that are impacting anesthesiologist practices. e ASA recommends CMS li these holds and develop guidance that improves the independent dispute resolution process. 3. Improve batching rules CMS policy batches anesthesia claims by limiting them to the same service facility, CPT code and payer, preventing anesthesiologists from efficiently batching claims. New guidance should align with provider- payer contracting practices based on an anesthesia conversion factor, ASA said. n Image Credit: Adobe Stock

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