Procedures Removed From the IPO List

Additionally, they removed 16 other procedures recommended by the Hospital Outpatient Payment Panel.

A version of this article was first published February 8, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: What procedures were removed from the inpatient-only (IPO) list starting January 1, 2021? What status indicators and APCs were they assigned to?

A: CMS finalized their proposal to remove 266 musculoskeletal procedures from the IPO list for CY 2021 as a first step to full elimination of the IPO list by 2024.

CMS also removed 16 related anesthesia codes based on comments they received to the proposed rule. Additionally, they removed 16 other procedures recommended by the Hospital Outpatient Payment Panel.

A spreadsheet with the list of removed codes is available from the CY2021 OPPS Final Rule website in the downloadable file named “Services Removed from the Inpatient Only (IPO) List for CY 2021.

The following is a summary of the status indicators and Ambulatory Payment Classifications (APC) assigned to codes removed from the list:

Status indicator N services:

• 16 anesthesia codes
• 18 musculoskeletal codes

Status indicator Q1 services:

• Two musculoskeletal codes - APC rate $2,830.40

Status indicator T services:

• One gastrointestinal code (44314) – APC rate $3,522.15

Status indicator J1 services:

• Eight gastrointestinal codes – APC rates $1,625.02 - $5,028.52
• Three vascular procedure codes (37617, 35372, 35800) – APC rates $2,861.66 - $4,770.37
• Two endovascular procedure codes ((37812, 61624) – APC rates $10, 042.94 - $16,064.00
• One laparoscopic procedure code (38562) – APC rate $8,907.66
• One gynecological procedure code (56630) – APC rate $4,409.54
• 246 musculoskeletal procedures – APC rates $206.19 - $15868.13

For more information, see "Note from the instructor: Out with the inpatient-only list, in with the inpatient-probably list" by Kimberly Hoy, JD.