Patient Satisfaction: 100 consecutive patients were polled postoperatively 91% found it was less painful or comparable to procedures performed under local anesthesia at the dentist’s office.86% would prefer to be awake for further hand surgery.90% would recommend wide awake surgery to a friend. Study: Teo I, Lam W, Muthayya P,… Continue reading
This one-page graphic illustrates how leverage works using a sample point system. It also illustrates the difference between asking the carrier to cooperate and provide their total costs versus the clinic cost-accounting approach to determining your request amount. These are great for meetings or discussions with a cross-functional team. I… Continue reading
These are based on the level of care rendered. Each facility class has minimal equipment required on site. Class A facility: Provides for minor surgical procedures performed under topical, local, or regional anesthesia without preoperative sedation. Excluded are intravenous, spinal, and epidural routes; these methods are appropriate for Class B… Continue reading
Level I Office Surgery includes, but is not limited to minor procedures such as excision of skin lesions, moles, warts, cysts, lipomas and repair of lacerations or surgery limited to the skin and subcutaneous tissue performed under topical or local anesthesia not involving drug-induced alteration of consciousness other than minimal… Continue reading
While the information below refers to ASC’s it also applies to office-based surgical suites subject to state guidelines. For roughly 15 states (2021) level 1 anesthesia level does not require accreditation or state regulation; regulations change often so always confirm with your state medical board. AAAASF (American Association for Accreditation… Continue reading
Click on the State by State TAB for information on OBS rules, regulations and accreditation requirements by state. This is information only. Rules change often. Please confirm with your state regulators the current status and requirements for an office-based surgical suite. Last Updated April 2021. Alabama ALAlaska AKArizona AZArkansas AR… Continue reading
The attached spreadsheet, a much shortened version of the 2021 Medicare PFSRVU file, includes only 2021 Hand and Wrist Orthopedic Procedures with no SOSD in the following categories: Flexor And Extensor Tendon Repair Tendon Transfer Dupuytren Contracture Release Trigger Finger And Carpal Tunnel Release Surgical Treatment Of Metacarpal And Phalangeal… Continue reading
Below are 2021 charges for Code 29848 and 64721. Reimbursement Information Wrist Endoscopy / Surgery Carpal Tunnel Surgery (Open) CPT™ Code: 29848 64721 PFS Relative Value Units: 15.12 12.37 Medicare Allowable (Physician Services Fee): $490.04 $446.43 Facility Fee Payment Weight: ASC: 14.7803 16.6878 Facility Fee Reimbursement: ASC: $723.53 $796.79 Facility… Continue reading
As promised this is an in-depth look into IOECTR, WALANT, and OBS. It was updated Sept 2, 2021 My goal with this guidebook is to provide information on how to set up and be fairly reimbursed for In-Office Endoscopic Carpal Tunnel Release (IOECTR). In other words, how to set up… Continue reading
One Visio Graphic is a one-page IOECTR Project Overview The other is a one-page graphical representation of the issues. These include OBS, WALANT, SOSD, reimbursement, setup, accreditation and others. Also included is a more-detailed one-page explanation of the issues above.
Below is a one-page Spreadsheet for establishing and obtaining reasonable reimbursement for an Office-based-surgical suite, WALANT and/or In-Office Endoscopic Carpal Tunnel Release. Last update: JAN 2022. This checklist is to help surgeons who perform endoscopic carpal tunnel release in the office setting (POS=11 / office) negotiate optimal reimbursement. Related terms… Continue reading
This is specifically for procedures that do not have a Site-of-Service Differential! There are at least 97 hand-and-wrist procedures so this applies to many procedures, not just IOECTR. This is a Step-by-Step Guide on strategies and approaches to negotiating a “carve-out” reimbursement for In-Office Endoscopic Carpal Tunnel Release with an… Continue reading
Overview: The attached Spreadsheet includes the detail for the following: Total orthopedic procedures = 1,645Orthopedic codes without a Site of Service Differential (SOSD)= 1174. 71% of all orthopedic procedures. NON-FAC NA INDICATOR = NA.These procedures are considered “facility only” and there is no additional reimbursement when performed in an office-based… Continue reading
Leverage: Identify your clinic’s leverage before entering negotiations with a health plan. How many surgeons perform ECTR in your city? Unique Services: Does your practice offer any unique services that will benefit the health plan and its members? Patient Mix: An OBS / WALANT clinic can accept patients not appropriate… Continue reading
Practice expenses for services provided in a physician’s office include: 1. Clinical Staff Time 2. The Equipment 3. Supplies Typically Used During A Procedure 4. Indirect Expenses Of A Physician Practice Such As Administrative Staff 5. Building Space 6. Office Supplies Considered overhead or “facility fees” whether NON-FAC PE is… Continue reading
This list is our 10-day global procedures with comparable Facility PE RVU’s (7.14) to code 29848. CPT Description Global NON FAC PE RVU FAC PE RVU WORK RVU MALPR TOT NON FAC RVU TOT RVU TOT FAC RVU 58661 Laparoscopy remove adnexa 10 5.71 11.35 1.8 18.86… Continue reading
This is an interesting list. Based on comparable Work RVU’s to ECTR (code 29848) of 6.39 and technically considered “minor surgery” there are significant facility fees associated with most of them—higher in fact than those of our comparable 90-day global list. CPT Description NON FAC PE RVU FAC PE RVU… Continue reading
In our effort to compare and contrast different procedures I analyzed 10-day global procedures. These are generally considered “office” procedures. CPT Description Global NON FAC PE RVU FAC PE RVU WORK RVU MALPR TOT NON FAC RVU TOT RVU TOT FAC RVU 11646 Exc f/e/e/n/l mal+mrg >4 cm 10 7.4… Continue reading
CPT Description Global NON FAC PE RVU FAC PE RVU WORK RVU MALPR TOT NON FAC RVU TOT RVU TOT FAC RVU 24130 Removal of head of radius 90 7.06 6.42 1.21 14.69 29834 Elbow arthroscopy/surgery 90 6.55 6.42 1.22 14.19 58805 Drainage of… Continue reading
The codes listed below have similar facility PE RVU’s to 29848. CPT Description Global NON FAC PE RVU FAC PE RVU WORK RVU MALPR TOT NON FAC RVU TOT RVU TOT FAC RVU 27087 Remove hip foreign body 90 7.15 8.83 1.81 17.79 40527 Reconstruct lip with… Continue reading