Issue link: https://beckershealthcare.uberflip.com/i/583494
44 Key Specialties SI joint fusion is a relatively new procedure that illustrates this payer imbroglio well. At present, few payers approve this procedure in ASCs despite its profile as a highly suit- able and appropriate outpatient procedure. e cost of this procedure performed in a hospital could be 200 percent to 400 percent more than in an ASC, due to implant markups in hospitals. Dr. Wohns sees value in regular meetings between payers and ASC representatives to discuss updates. Spine is here to stay e outpatient surgery center environment oen yields lower infections rates, higher patient satisfactions rates and lower costs, according to Dr. Wohns. With those benefits, he sees spine continuing to gain momentum in ASCs. Additionally, ASCs provide opportunities for physicians to protect their independence outside of the hospital influence. "e future is a reflection of what is going on now, with more and more interested parties recognizing the value of outpatient spine surgery," says Dr. Wohns, "ese parties in- clude payers, government agencies, patients and providers." With the addition of spine codes, CMS realized the ben- efits of performing spine surgeries in outpatient surgery centers, recognizing the procedures as safe and cost-effec- tive for the Medicare beneficiaries. "We no longer need a hospital for the majority of spine sur- geries — it's an old way to do it," says Dr. Wohns. "In general, everything is higher quality, less costly, more efficient and less complicated in ASCs, and that's what people want." n mercurymed.com 800.237.6418 Your Need . . . Our Innovation ® ® ® ® ONLY ONE . . . Mercury Medical® We focus on developing airway technology that provides real-world solutions and improved patient outcomes. Contact us today about these three proven lifelines from one trusted brand name. HOW MANY AIRWAY SOLUTIONS DO YOU NEED TO REMEMBER? Visit t he Mercur y Medical Boot h #12F Becker 's ASC 22nd Annual Meeting Swissotel, Chicago, I llinois Oc tober 22 - 24, 2015 ACG: 7 GI/Endoscopy Coding & Billing Tips for Screening Colonoscopy By Carrie Pallardy C onfusion surrounding coding and billing can result in denied claims and delayed payment. Here are seven tips for coding screening colonoscopies, according to the American College of Gastroenterology. • Screening is performed on a patient with an absence of signs and symptoms. • Medicare defines average risk as no personal or family history of adenomatous polyps, colorectal cancer or inflammatory bowel disease. • Most payers set patient eligibility for screening colonoscopy at or aer age 50. • Since Jan. 1, 2011, Medicare waives co-pays and deductibles for the professional and facility fees for screening colonoscopy. • In Medicare's final rule for 2015, Medicare expanded its co-pay and deductible waiver to include anesthesia for screening colonoscopy. A -33 modifier should be added to the 00810 anesthesia code to indicate the circumstance was preventive, according to the report. • Medicare allows follow-up procedures every 10 years if the screening colonoscopy is negative. • Billing for an average risk screening patient includes G0121 (Medicare), and com- mercial, Medicaid, exchange/marketplace, Tricare: 45378 with the appropriate ICD-9 (through Sept. 30) or ICD-10 code (effective Oct. 1) for screening. n