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tci Outpatient Facility Coding Alert - 2012 Issue 1

Reader Question: Safety and Timeframes Drive ASC and Non-ASC Lists

Question: I know that some procedures are on the "approved" list for performing in an ASC, but others aren't. What's the rationale behind the lists? Montana Subscriber Answer: CMS deems whether a procedure should be covered in an ASC setting, and many other payers follow those guidelines. The list of ASC covered services include surgical procedures that CMS determines do not pose a significant safety risk and are not expected to require an overnight stay following the surgery. For example, cataract surgery (66983, Intracapsular cataract extraction with insertion of intraocular lens prosthesis [1 stage procedure]) and knee arthroscopy with...

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