ASCs: Re-examine these specialties for 2009
ASCs: Re-examine these specialties for 2009
Ambulatory surgery centers (ASCs) should re-examine their specialty services as they enter 2009 reimbursement, which will be 50% of the hospital outpatient department (HOPD) rate, according to Judith L. English, vice president of business operations and partner at Surgery Consultants of America (SCA) and Serbin Surgery Center Billing, both in Fort Myers, FL. English recently presented an audio conference on 2009 reimbursement for AHC Media, publisher of Same-Day Surgery.
Perform case costing to determine if you want to add some specialties, she advises. "If it doesn't cover the cost now, evaluate it year after year to see if sooner or later it will give you sufficient reimbursement to include in the list of procedures you want to do," she says.
Consider the following tips from English for specific specialties.
- Ear, nose, and throat (ENT). Carefully evaluate before adding ENT cases because the equipment is expensive, especially for sinus endoscopy, English says.
- Gastrointestinal. Monitor block utilization. For example, you may be staffing two rooms in order to keep procedures moving quickly, but your surgeon might be using only one-third of his or her day.
- General surgery. General surgery sees several additions, including cardiac and vascular procedures, ancillary procedures, and office-based reimbursement for simpler procedures and lesions, English says.
- GYN. Evaluate the practicality of adding procedures against equipment and supply purchases, English advises. "Several procedures can be done on Medicare-age patients," she says.
- Ophthalmology. Consider adding or increasing retinal cases, which show an increase for 2009.
- Orthopedics. Perform careful case costing to determine your profit margin on these cases during the transition to HOPD reimbursement, English advises. You might need to wait until year three or four before reimbursement will be sufficient to make a profit, she suggests.
- Pain management. Injections and other procedures are very low cost, English says. Consider these cases if you already are offering orthopedic or spine cases, which are good referral sources, she adds.
- Podiatry. This is a good specialty to evaluate if you are offering orthopedic cases, because they have similar equipment and supplies, English says.
- Urology. "This is a sleeper," English says. Lithotripsy, brachytherapy, and prostate surgeries have increased in reimbursement for 2009, she says. "It takes special equipment, usually a special table," English says. "It's an investment, but you might want to look at it as a specialty to add." [Editor's note: In the Sept. 5 Same-Day Surgery Weekly Alert, we told you about nine new non-office-based procedures that will be paid 100% for the first year. If you haven't yet signed up to receive the weekly alerts, contact customer service at [email protected] or call (800) 688-2421.]
Resource
The CD from the audio conference "Ready, Set, Go! Preparing for the 2009 CMS Payment Systems for Ambulatory Surgery Centers" is available for purchase for $249. Call (800) 688-2421 or go to www.reliasmedia.com. Click on "products and services" and then view "By Media Type." Under "Audio Conference CDs," click on the CD title. Mention product code 10T08269.
Ambulatory surgery centers (ASCs) should re-examine their specialty services as they enter 2009 reimbursement, which will be 50% of the hospital outpatient department (HOPD) rate, according to Judith L. English, vice president of business operations and partner at Surgery Consultants of America (SCA) and Serbin Surgery Center Billing, both in Fort Myers, FL.Subscribe Now for Access
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