Orthopedic Surgeries Continue to Surge

Total hip and knee surgeries continue their migration to the outpatient setting, according to a recent article in OrthoWorld, by Ernie Robles RN, BS, a consulting director for Vizient with 30 years of experience in clinical, revenue cycle and operational roles. He notes,”Much has been written in recent years about total hip and total knee arthroplasty procedures exiting inpatient settings. This migration is expected to continue, according to Sg2, a Vizient company.”

He writes, “The Medicare Inpatient Only (IPO) procedure list qualifies the site of service by emphasizing patient safety and quality outcomes, and it is considered a standard for what can and cannot be performed on an outpatient basis. The IPO list, along with the addenda and fee schedules for the Outpatient Prospective Payment System (OPPS) covering hospital outpatient departments (HOPD) and the Ambulatory Surgery Center (ASC) system, can provide insight into the remaining procedures with opportunity for future Medicare beneficiary growth in ambulatory settings.”

“Though many of the more complex orthopedic surgeries have moved off the IPO list and are now allowed in an HOPD, a few key procedures are not covered by Medicare when performed in an ASC. At the forefront of these procedures are opportunities in shoulder and ankle arthroplasty, as well as spinal procedures — especially fusions,” writes Robles. OSM