ASC administrators are dismayed by CMS' proposal to bump 298 musculoskeletal-related procedures back to its inpatient-only list next year.
The proposal has been described as "an obvious step backwards" by administrators who question how much data CMS has collected to back up the "patient safety concerns" cited as the reason to remove the 298 procedures from its IPO list.
It has been less than a year since CMS removed the 298 procedures from its IPO list, with many surgery centers closed early in 2021 because of the COVID-19 pandemic.
The procedures that could be bumped back to the IPO list, which CMS has also proposed to reinstate, primarily relate to knee, hip, shoulder and spine.
Here are the 71 spine-related procedures and their codes that CMS may not pay for at ASCs next year:
Note: CPT codes and descriptions, available on CMS' website, are subject to copyright of the American Medical Association.
|
CY 2021 CPT Code |
CY 2021 Short Descriptor |
CY 2021 Long Descriptor |
|
00604 |
Anesth sitting procedur |
Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position |
|
0095T |
Rmvl artific disc addl crvcl |
Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) |
|
0098T |
Rev artific disc add |
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) |
|
0163T |
Lumb artif discectomydiskectomy addl |
Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to code for primary procedure) |
|
0164T |
Remove lumb artif disc add |
Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) |
|
0165T |
Revise lumb artif disc addl |
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) |
|
0202T |
Post vert arthrplst 1 lumba |
Posterior vertebral joint(s) arthroplasty (for example, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine |
|
0219T |
Plmt post facet implt cerv |
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical |
|
0220T |
Plmt post facet implt thor |
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic |
|
0220T |
Plmt post facet implt thor |
Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic |
|
22010 |
I&d p-spine c/t/cerv-thor |
Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic |
|
22015 |
I&d abscess p-spine l/s/ls |
Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral |
|
22110 |
Remove part of neck vertebra |
Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical |
|
22112 |
Remove part thorax vertebra |
Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic |
|
22114 |
Remove part lumbar vertebra |
Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar |
|
22116 |
Remove extra spine segment |
Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure) |
|
22206 |
Incis spine 3 column thorac |
Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); thoracic |
|
22207 |
Incis spine 3 column lumbar |
Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); lumbar |
|
22208 |
Incis spine 3 column adl seg |
Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure) |
|
22210 |
Incis 1 vertebral seg cerv |
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical |
|
22212 |
Incis 1 vertebral seg thorac |
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic |
|
22214 |
Incis 1 vertebral seg lumbar |
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar |
|
22216 |
Incis addl spine segment |
Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure) |
|
22220 |
Incis w/discectomy cervical |
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical |
|
22222 |
Incis w/discectomy thoracic |
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic |
|
22224 |
Incis w/discectomy lumbar |
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar |
|
22226 |
Revise extra spine segment |
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure) |
|
22318 |
Treat odontoid fx w/o graft |
Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting |
|
22319 |
Treat odontoid fx w/graft |
Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting |
|
22325 |
Treat spine fracture |
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar |
|
22326 |
Treat neck spine fracture |
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical |
|
22327 |
Treat thorax spine fracture |
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic |
|
22328 |
Treat each add spine fx |
Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure) |
|
22532 |
Lat thorax spine fusion |
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic |
|
22533 |
Lat lumbar spine fusion |
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar |
|
22534 |
Lat thor/lumb addl seg |
Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure) |
|
22548 |
Neck spine fusion |
Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process |
|
22556 |
Thorax spine fusion |
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic |
|
22558 |
Lumbar spine fusion |
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar |
|
22586 |
Prescrl fuse w/ instr l5-s1 |
Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace |
|
22590 |
Spine & skull spinal fusion |
Arthrodesis, posterior technique, craniocervical (occiput-c2) |
|
22595 |
Neck spinal fusion |
Arthrodesis, posterior technique, atlas-axis (c1-c2) |
|
22600 |
Neck spine fusion |
Arthrodesis, posterior or posterolateral technique, single level; cervical below c2 segment |
|
22610 |
Thorax spine fusion |
Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed) |
|
22630 |
Lumbar spine fusion |
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar |
|
22632 |
Spine fusion extra segment |
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (list separately in addition to code for primary procedure) |
|
22800 |
Post fusion </6 vert seg |
Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments |
|
22802 |
Post fusion 7-12 vert seg |
Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments |
|
22804 |
Post fusion 13/> vert seg |
Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments |
|
22808 |
Ant fusion 2-3 vert seg |
Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments |
|
22810 |
Ant fusion 4-7 vert seg |
Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments |
|
22812 |
Ant fusion 8/> vert seg |
Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments |
|
22818 |
Kyphectomy 1-2 segments |
Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments |
|
22819 |
Kyphectomy 3 or more |
Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments |
|
22830 |
Exploration of spinal fusion |
Exploration of spinal fusion |
|
22841 |
Insert spine fixation device |
Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure) |
|
22843 |
Insert spine fixation device |
Posterior segmental instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure) |
|
22844 |
Insert spine fixation device |
Posterior segmental instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure) |
|
22846 |
Insert spine fixation device |
Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure) |
|
22847 |
Insert spine fixation device |
Anterior instrumentation; 8 or more vertebral segments (list separately in addition to code for primary procedure) |
|
22848 |
Insert pelv fixation device |
Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure) |
|
22849 |
Reinsert spinal fixation |
Reinsertion of spinal fixation device |
|
22850 |
Remove spine fixation device |
Removal of posterior nonsegmental instrumentation (for example, harrington rod) |
|
22852 |
Remove spine fixation device |
Removal of posterior segmental instrumentation |
|
22855 |
Remove spine fixation device |
Removal of anterior instrumentation |
|
22857 |
Lumbar artif diskectomy |
Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar |
|
22861 |
Revise cerv artific disc |
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical |
|
22862 |
Revise lumbar artif disc |
Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar |
|
22864 |
Remove cerv artif disc |
Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical |
|
22865 |
Remove lumb artif disc |
Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar |
|
G0412 |
Open tx iliac spine uni/bil |
Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed |
|
G0414 |
Pelvic ring fx treat int fix |
Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami) |