Issue link: https://beckershealthcare.uberflip.com/i/759246
12 SPINE LEADERSHIP Dr. Richard Wohns on the Impact of the New 10 ASC Payable Spine Codes By Megan Wood P ayers have posed as obstacles for spine in ambulatory surgery centers, but the recent additions and proposals of ASC payable codes for spine procedures should ease up some of the difficulties surgery centers face. CMS added 10 new ASC payable codes for 2017: 1. Autogra for spine surgery (20936) — (in- cludes harvesting the gra); local (eg, ribs, spinous process or laminar fragments) ob- tained from the same incision (List separately in addition to code for primary procedure) 2. Autogra for spine surgery only (20937) — (includes harvesting the gra); morselized (through separate skin or fascial incision) (List separately in addition to code for prima- ry procedure) 3. Autogra for spine surgery only (20938) — (includes harvesting the gra); structural bio- cortical or tricortical (through separate skin fascial incision) 4. Arthrodesis, anterior interbody (22552) — including disc space preparation, discectomy, osteophytectomy and decompression of spi- nal cord and/or nerve roots; cervical C2, each additional interspace (List separately in addi- tion to code for separate procedure) 5. Posterior non-segmental instrumentation (22840) — (eg, Harrington rod technique, pedicle screw fixation across one interspace, atlantoaxial transarticular screw fixation, sub- laminar wiring at C1, facet screw fixation) 6. Posterior non-segmental instrumentation (22842) — (eg, Harrington rod technique, pedicle fixation across one interspace, atlan- toaxial transarticular screw fixation, sublimi- nar wiring at C1, facet screw fixation) 7. Insert spinal fixation device (22845) 8. Insertion of interbody biomechanical de- vice(s) (22853) 9. Insertion of intervertebral biomechanical device(s) (22854) 10. Insertion of intervertebral biomechanical device(s) (22859) Richard Wohns, MD, JD, MBA, of Puyallup, Wash.-based NeoSpine, offers his take on the surge of spine into the outpatient setting. "[ere will be] increased opportunity for more surgeries to be performed in an out- patient center rather than in a hospital, for appropriate Medicare cases," Dr. Wohns says. He has already seen the impact of the ASC payable spine codes added in 2015: 1. [Neck spine fuse & remov bel c2 (22551)] 2. Neck spine fusion (22554) 3. Lumbar spine fusion (22612) 4. Neck spine disc surgery (63020) 5. Low back disc surgery (63030) 6. Laminectomy single lumbar (63042) 7. Removal of spinal lamina (63045) 8. Removal of spinal lamina (63047) 9. Decompression spinal cord (63056) Since the addition of these payable codes, NeoSpine has experienced a 12 percent in- crease in its outpatient spine surgery volume, tied to Medicare patients possessing the op- tion of undergoing outpatient spine surgery in ASCs. "More and more spine procedures are being performed outpatient and more and more spine procedures should be performed outpa- tient," he says. Patients undergoing outpatient spine surgery experience higher satisfaction rates and enhanced outcomes, he adds. "And there is lower cost related to outpatient spine surgeries compared to inpatient proce- dures," says Dr. Wohns. Due to implant cost markups and operating room time in hospitals, ASCs can see a 60 percent cost savings over a hospital when per- forming the same spine surgery, according to the Society for Ambulatory Spine Surgery. As healthcare dives deeper into a value-based world, outpatient spine surgery will likely continue gaining traction with the motto of higher quality and lower costs. n SpineNevada Offers Advanced Imaging With InMotion Diagnostics — 6 Highlights By Megan Wood S pineNevada's InMotion Diag- nostics provides an imaging platform to measure instability through spinal motion. Here are six highlights: 1. SpineNevada implemented the Esaote G-Scan Brio, which is the In- Motion MRI system designed for im- aging in both the supine position and standing positions. 2. The InMotion MRI provides a high level of musculoskeletal condition evaluation. 3. The Vertebral Motion Analysis of- fers surgeons imaging data to help identify the source of spinal compli- cations. 4. Specifically, the VMA measures spine motion to test for instability. 5. SpineNevada also utilizes the digi- tal X-ray platform, GE Optima XR646, which creates high-quality images with low X-ray exposure. 6. SpineNevada Minimally Invasive Spine Institute has locations in Reno, Sparks and Carson City. n Dr. Richard Wohns