ASCQR PROGRAM SURGICAL PROCEDURE CODES FOR ASC-7
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1 ASCQR PROGRAM SURGICAL PROCEDURE CODES FOR ASC-7 This document summarizes the Ambulatory Surgical Center Quality Reporting (ASCQR) Program surgical procedure codes, grouped by organ system, to be used in answering measure ASC-7: ASC Facility Volume Data on Selected ASC Surgical Procedures. All codes were found on unless otherwise noted. The reference period for the collection of these data is January 1, 2014 through December 31, These data are to be submitted via the QualityNet Secure Portal during the submission period of January 1, 2015 through August 15, If you have any questions, please us at or call us toll-free at from 7 a.m. to 6 p.m. ET. Organ System: Eye Organ transplant (eye) Keratoplasty (corneal transplant); endothelial V2785* Processing, preserving and transporting corneal tissue Laser procedure of eye Trabeculoplasty by laser surgery, one or more sessions (defined treatment series) Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (per session) Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., yag laser) (one or more stages) Glaucoma procedures Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery Ciliary body destruction; cyclophotocoagulation, endoscopic Cataract procedures Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification) Injection of eye Intravitreal injection of a pharmacologic agent (separate procedure) J2778* Injection, ranibizumab, 0.1 mg J3300* Injection, triamcinolone acetonide, preservative free, 1 mg Retina, macular, and posterior segment procedures Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (e.g., for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (i.e., air, gas, or silicone oil) Destruction of localized lesion of retina (e.g., macular edema, tumors), one or more sessions; photocoagulation Repair of surrounding eye structures Blepharoplasty, upper eyelid; with excessive skin weighting down lid Repair of brow ptosis (supraciliary, mid-forehead, or coronal approach) Repair of blepharoptosis; (tarso) levator resection or advancement, external approach Repair of ectropion; extensive (e.g., tarsal strip operations) Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation) June 2014 Page 1 of 6
2 Organ System: Gastrointestinal GI endoscopy procedures Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) Sigmoidoscopy, flexible; with biopsy, single or multiple Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s), any substance Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique Hemorrhoidectomy, internal, by rubber band ligation(s) Swallowing tube (esophagus) Dilation of esophagus, by unguided sound or bougie, single or multiple passes Hernia repair Repair initial inguinal hernia, age five years or older; reducible GI screening procedures G0105* Colorectal cancer screening; colonoscopy on individual at high risk G0121* Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk June 2014 Page 2 of 6
3 Organ System: Genitourinary Kidney stone fragmentation Lithotripsy, extracorporeal shock wave Bladder-related procedures Cystourethroscopy (separate procedure) Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., gibbons or double-j type) Prostate biopsy Biopsy, prostate; needle or punch, single or multiple, any approach Radiologic procedures (GU) Urography, retrograde, with or without KUB Ultrasound procedures (GU) Ultrasound, transrectal June 2014 Page 3 of 6
4 Organ System: Musculoskeletal Joint or muscle aspiration or injection Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa) Removal of musculoskeletal implants Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod, or plate) Repair of foot, toes, fingers, and wrist Tendon sheath incision (e.g., for trigger finger) Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure) Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy) Correction, hallux valgus (bunion), with or without sesamoidectomy; with metatarsal osteotomy (e.g., mitchell, chevron, or concentric type procedures) Endoscopy, wrist, surgical, with release of transverse carpal ligament Joint arthroscopy Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure) Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code for primary procedure) Arthroscopy, shoulder, surgical; with rotator cuff repair Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed Joint or muscle aspiration or injection Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed Arthroscopy, shoulder, surgical; debridement, extensive Arthroscopy, shoulder, surgical; debridement, limited Musculoskeletal drug injection J0585* Injection, onabotulinumtoxina, 1 unit J0878* Injection, daptomycin, 1 mg J0131* Injection, acetaminophen, 10 mg June 2014 Page 4 of 6
5 Organ System: Nervous Injection procedures in or around the spine Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional level (list separately in addition to code for primary procedure) Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (list separately in addition to code for primary procedure) Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure) Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure) Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure) Destruction by neurolytic agent; other peripheral nerve or branch G0260* Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography J2278* Injection, ziconotide, 1 mcg Device implant Percutaneous implantation of neurostimulator electrode array, epidural Repair of foot, toes, fingers, and wrist Neuroplasty and/or transposition; median nerve at carpal tunnel June 2014 Page 5 of 6
6 Organ System: Respiratory Sinus procedure Submucous resection inferior turbinate, partial or complete, any method Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior) Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus Organ System: Skin Skin procedures including debridement, reconstructive, wound closure, excision and/or repair Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq. cm or less Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq. cm or less Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq. cm or less Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq. cm or less Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) Q4101* Apligraf, per square centimeter Q4102* Oasis wound matrix, per square centimeter Q4106* Dermagraft, per square centimeter Organ System: Multi-System Brachytherapy C2638* Brachytherapy source, stranded, iodine-125, per source C2639* Brachytherapy source, non-stranded, iodine-125, per source C2640* Brachytherapy source, stranded, palladium-103, per source C2641* Brachytherapy source, non-stranded, palladium-103, per source Cancer treatment with angiogenesis inhibitor C9257* Injection, bevacizumab, 0.25 mg * Source: This material was prepared by FMQAI, the Support Center for the Ambulatory Surgical Center Quality Reporting program, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). The contents presented do not necessarily reflect CMS policy. FL-10SOW-2014FS4T June 2014 Page 6 of 6
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