Becker's Spine Review

49 OUTPATIENT SURGERY Investors Turn to ASCs, Urgent Care Centers as Hospital Demand Declines: 5 Things to Know By Mary Rechtoris H ospitals, insurers and employers looking to thrive in the competitive healthcare landscape are eyeing surgery centers and urgent care centers as a means to provide quality care at a reduced cost, according to Fox Business. Here are five things to know: 1. Many hospital operators are investing in ASCs as hospital demand drops. American Hospital Association data shows Tenet Healthcare's hospital admission has either remained stagnant or dropped between 1 percent and 3 percent for the majority of quarters since late 2015. 2. RBC Capital Markets Managing Director Frank Morgan, a hospital analyst, told Fox Business ASC investments prove to be an essential strategy to appeal to patients who are looking for lower cost options. 3. UC, Berkeley researchers found employees and retirees with California Public Employees' Retirement System insur- ance paid between $2,500 and $5,000 less when having cat- aract surgery and knee arthroscopies at ASCs as opposed to hospitals. 4. Hospital Corporation of America Chairman and Chief Ex- ecutive Milton Johnson said the company plans to open 120 freestanding urgent care centers by the end of 2017. This fig- ure is a 40 percent increase in new facilities since 2015. 5. Over the past five years, HCA's market share in Nashville increased from 32 percent to 35 percent. HCA added three ASCs, four freestanding emergency rooms and 10 urgent care centers during that time. n • multiple sphincterotomies • IOL requires additional support, such as a capsular tension ring or intraocular sutures • implantation of an IOL in a pediatrics case • mature cataract requiring the use of dye Billing separately for IOL used in a cataract extraction proce- dure — When coding any of the cataract extraction or other pro- cedures involving IOLs (66982 through 66986) to Medicare, these codes include the insertion of an IOL in the procedure. These CPT codes include $150.00 reimbursement for the IOL. Medicare will pay the same amount for cataract extraction with A-C IOL inser- tion that it pays for cataract extraction with conventional IOL in- sertion. The only time V2632 (conventional or A-C IOL) can be coded separately is when the procedure is performed in a provid- er's office. However, there are two lenses that can be coded for Medicare patients. e astigmatism-correcting lens (e.g., Toric) is billed with V2787 and the presbyopia-correcting lens (e.g., Restor) is billed with V2788. When billing for these lenses, remember to allow a $150.00 credit already included in the Medicare allowances for these procedures. Commercial payer policies may vary. Part II Part II of this two-part series on coding errors in the ASC will focus on two additional specialties: podiatry and ENT. is second part will also provide generic coding hints applicable to most specialties. n OrthoNY Seeks Approval for $5.6M ASC, Projects $5.8M Revenue in 1st year: 5 Key Notes By Laura Dyrda O rthoNY plans to expand its orthopedic practice with a new multispecialty ASC, according to The Daily Gazette. Here are five things to know: 1. OrthoNY submitted an application to the New York Public Health and Health Planning Council at the coun- cil's meeting this past week to seek contingent approv- al for their new project: a 12,000-square-foot ASC. The practice plans to lease space and build it into a four operating room ASC. 2. The project is expected to cost $5.6 million and bring in around $5.8 million in revenue for the first year. OrthoNY estimates the surgery center would perform more than 3,000 procedures during its first year open. 3. Building would begin on or before March 1, 2018, pending approval, and the practice hopes to have con- struction completed by Dec. 31 of next year. 4. The new ASC would be located in a county with three ASCs that saw around 20,342 patients last year. The multispecialty center would include orthopedics as well as other specialties. 5. OrthoNY has 12 offices currently and plans to employ 23 new full time employees to staff the new ASC. n

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