New ASC conditions of coverage

New rules regarding conditions of coverage for ambulatory surgery centers (ASCs) become effective on May 19, 2009. These are the first changes to the conditions of coverage since 1982. Final regulations were published in the November 18, 2008 Federal Register.

The new regulation revises the definition of an ASC. It now states: “Ambulatory surgical center or ASC means any distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization, and in which the expected duration of services would not exceed 24 hours following an admission.” Previously, ASCs were unable to provide monitoring extending beyond midnight. This change would let patients remain in an ASC for up to 23 hours and 59 minutes from the start of admission if necessary.

Of particular note for ophthalmology will be the time frame associated with a pre-operative history and physical. The following excerpt comes from the patient admission, assessment, and discharge condition of coverage.

“(a) Standard: Admission and pre-surgical assessment. (1) Not more than 30 days before the date of the scheduled surgery, each patient must have a comprehensive medical history and physical assessment completed by a physician (as defined in section 1861(r) of the Act) or other qualified practitioner in accordance with applicable State health and safety laws, standards of practice, and ASC policy.”

Additional rule changes include revisions to the following conditions:

  • Governing body and management
  • Quality assessment and performance improvement
  • Patient rights
  • Patient admission, assessment, and discharge

Complete details can be found in the Federal Register document at:

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