Member Focus

Member Focus invites ASCA members to express their views on key ASC issues. Share your perspective with your colleagues and get to know your peers in the ASC community.

Want to be the next featured member?

Answer one or both of the following questions:

Is your facility billing for non-opioid alternatives? Any words of advice to others?
Do you have a different time frame for H&Ps from the 30-day window? What criteria did you use to support making the change?

Questions? Write Sahely Mukerji.

Rob Taylor, RN

Title: Clinical Director & Total Joint Coordinator
Facility Name: Constitution Surgery Center East
City: Waterford
State: Connecticut
Length of time your facility has been an ASCA member: Five or more years

Is your facility billing for non-opioid alternatives? Any words of advice to others?

We perform many cryoneurolysis procedures for our patients undergoing total knee replacement. This has resulted in significant decreases in the use of opioids postoperatively. Reimbursement for these procedures was strengthened recently by the passage of the NOPAIN Act. It is important to space these treatments two weeks out from their scheduled surgery. We have a few instances where insurance companies have denied the claim if we perform the procedure within the two-week window, claiming it must be bundled with the surgery.

Do you have a different time frame for H&Ps from the 30-day window? What criteria did you use to support making the change?

With the passage of the 2019 CMS Burden Reduction Final Rule, 42 CFR § 416.52(a), we adjusted our H&P time frame to 90 days. Our surgical consent form was valid for 90 days, so this made sense. It is important to know your state licensure regulations, because many states still require adherence to the 30-day rule.

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