2019 ASC Proposed Payment Rates

Transcription

1 Injection, therapeutic tendon sheath, ligament injection Tendon origin/insertion injection $39.38 $39.76 $39.48 $39.96 $ % -0.6% $29.72 $30.09 $23.69 $24.12 $ % -1.2% $31.51 $31.52 $31.94 $32.40 $ % -24.5% Single or multiple trigger point(s), one or two muscle group(s) $30.07 $30.09 $30.15 $30.24 $ % 0.5% 1% Single or multiple trigger point(s), three or more muscle groups $35.44 $35.10 $35.17 $35.28 $ % 0.5% Small joint injection Intermediate joint injection Major joint injection Vertebroplasty (Cervicothoracic) Vertebroplasty (Lumbosacral) Kyphoplasty, thoracic Kyphoplasty, lumbar Insj stablj dev w/o dcmprn Sacroiliac joint Fusion Percutaneous epidural adhesiolysis - 2 or 3 days Percutaneous epidural adhesiolysis 1 day Percutaneous aspiration, spinal cord cyst or syrinx Biopsy of spinal cord, percutaneous needle Spinal puncture, diagnostic $22.20 $22.57 $22.61 $23.04 $ % -2.8% $23.63 $24.00 $24.05 $24.48 $ % -2.7% $28.64 $29.01 $29.07 $29.16 $ % -3.4% -1.3% -22.2% -23.4% $1,339.0 $1, $1, $1, $1, $1, % 4.2% -5.3% -11% -5% $1,339.0 $1, $1, $1, $1, $1, % 4.2% -5.3% -11% -5% $3, $3, $2, $2, $2, % $3, $3, $2, $2, $2, % $12, $12, % -2.5% -3.2% -21.4% -21.4% $183.8 $ $ $ $ $ % % 9% 118% $333.0 $ $ $ $ $ % 5.9% 4.7% -4% 66% -21% -23% -1% -1% -2% -2-2

2 Spinal puncture, therapeutic Epidural, blood patch Subarachnoid neurolytic injection Neurolytic epidural, C/T Neurolytic epidural, L/S Disc decompression Chemonucleolysis Cervical epidural Lumbar epidural Catheterization, epidural, L/S Cervical/Thoracic epidural without imaging guidance Cervical/Thoracic epidural WITH imaging guidance Lumbar/Caudal epidural without imaging guidance Lumbar/Caudal epidural WITH imaging guidance $333.0 $ $ $ $ $ % 15.2% -3.6% -14% -5% $1,339.0 $1, $1, $1, $2, $1, % 4.1% 3.3% 21% 47% $ $ $ $ $ % $333.0 $ $ $333.0 $ $ $333.0 $ $ $333.0 $ $ $0.0 $0.00 $ $ $ % 15.2% $0.0 $ $ $ $ $ % 15.2% $0.0 $0.00 $ $ $ % 15.2% $0.0 $ $ $ $ $ % 15.2% without imaging guidance $0.0 $0.00 $ $ $ % 16. WITH imaging guidance $0.0 $ $ $ $ $ % % Epidural or subarachnoid, catheterization, L/S without imaging guidance $0.0 $0.00 $ $ $ % 16. Epidural or subarachnoid, catheterization, L/S WITH imaging guidance $0.0 $ $ $ $ $ % % 1.9% -3.6% -3.6% -2% -14% -14%

3 Tunneled intrathecal or epidural catheter Removal or previously implanted intrathecal or epidural catheter Implant or replacement of subcutaneous reservoir $446.0 $2, $1, $1, $2, $2, % 35.6% 34.6% 27% 473% $446.0 $ $ $ $ $ % 1.9% -2% 78% $446.0 $2, $12, $12, $13, $13, % 6.2% % 2875% Implantation or replacement of non-programmable pump $446.0 $13, $12, $13, $13, $12, % -1.8% 0.2% -2% 2795% Implant spine infusion pump Remove spine infusion device Electronic analysis of programmable pump Electronic analysis of programmable pump with reprogramming Endoscopic Decompression of Lumbar Spine Implant neuroelectrodes Implant neuroelectrodes Remove spine eltrd perq aray Remove spine eltrd plate Remove spine eltrd perq aray Remove spine eltrd plate Implant neuroreceiver Revise/remove neuroreceiver Injection, Trigeminal nerve Greater occipital nerve $446.0 $13, $12, $13, $13, $13, % 2.7% 5. 2% 2935% $446.0 $1, $1, $1, $2, $1, % 4.1% 3.3% 21% 34 $22.91 $23.28 $22.97 $24.48 $ % -7.5% $31.51 $31.88 $30.86 $32.04 $ % -6.6% $3, $2, $2, % $446.0 $3, $3, $4, $4, $4, % 3.8% % $15, $14, $14, $15, $15, % 7.5% $ $ $ $ $ % $1, $1, $1, $1, $1, % 10.5% $3, $3, $4, $3, $4, % -4.6% $3, $3, $13, $12, $14, % 3.8% -8.7% -9.6% 6.7% 1.9% 31.1% 7.3% 255.1% $446.0 $20, $21, $23, $22, $22, % 5.5% 8% 493 $333.0 $1, $1, $1, $1, $1, % 10.5% 31.1% 37% 382% $81.98 $82.75 $82.19 $86.04 $ % 9.5% $62.29 $63.04 $62.09 $64.44 $ % -27.5% 8.8% -28.6% -7% -9% 5% 37% 12% %

4 Vagus nerve Phrenic nerve Cervical plexus Brachial plexus Axillary nerve Suprascapular nerve Intercostal, single Intercostal, multiple, regional block Ilioinguinal, Iliohypogastric Sciatic nerve Other peripheral nerve or branch Cervical transforaminal epidural injections Lumbar/sacral transforaminal epidural injections Cervical and thoracic facet joint injections, 1st Level $63.37 $52.30 $63.88 $64.44 $ % -4.7% $333.0 $ $ $ $ $ % % 246% 2 $73.75 $73.07 $72.50 $72.72 $ % $139.0 $ $ $ $ $ % % 188% $139.0 $ $ $ $ $ % % 96% 188% $96.66 $97.07 $95.46 $76.32 $ % -44.6% 16.4% -2.4% -45.5% $65.16 $67.34 $65.32 $68.40 $ % 8.6% $78.76 $82.03 $79.31 $82.08 $ % 4.4% $52.27 $52.30 $52.04 $52.56 $ % -5.9% Paravertebral facet joint or facet joint nerve; lumbar/sacral, 1st Level Injection, sphenopalatine ganglion Injection, Carotid sinus (separate procedure) Injection, Stellate ganglion (cervical sympathetic) $52.27 $53.01 $53.12 $55.44 $ % 18.6% $14.68 $18.63 $15.79 $7.20 $ % 5.3% % 18.9% -59.4% Injection, lumbar or thoracic (paravertebral sympathetic) -4% -3% -45% 9% 5% -6% 21% -49%

5 G0260 Injection, celiac plexus, Destruction by neurolytic agent, trigeminal nerve Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale $333.0 $ $ $ $ $ % 1.9% 5% 138% Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen $333.0 $ $ $ $ $ % 1.9% 5% 138% Chemodenervation of muscle(s); muscle(s) innervated $72.68 $73.43 $72.85 $75.96 $ % 5.8% 4.9% 6% Intercostal nerve - neurolysis Pudendal nerve - neurolysis Paravertebral facet joint nerve; C/T, single level - - neurolysis $351.9 $ $ $ $ $ % % 14% $333.0 $ $ $ $ $ % 1.9% -2% 138% Paravertebral facet joint nerve; L/S, single level - - neurolysis $333.0 $ $ $ $ $ % 1.9% -2% 138% Other peripheral nerve or branch - - neurolysis Celiac plexus - - neurolysis (27096) Sacroiliac joint, arthrography No payments for all Add-on codes $87.71 $88.48 $86.85 $87.84 $ % $391.0 $ $ $ $ $ % % $333.0 $ $ $ $ $ % 15.2% -3.6% -14% -5% -0.7%