7 musculoskeletal codes will not return to the IPO list in 2022, CMS says


On Jan. 1, 2021, in accordance with the 2021 OPPS/ASC final rule, CMS removed 298 codes, including 266 musculoskeletal-related services, from the inpatient-only list, which it had proposed to gradually phase out by 2024.

But in 2022 the agency is walking back its proposed elimination of the IPO list and returning the services removed from it in 2021, excluding CPT codes 22630 (lumbar spine fusion), 23472 (reconstruct shoulder joint), 27702 (reconstruct ankle joint) and their corresponding anesthesia codes below:

  • 22630: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar

  • 23472: Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (for example, total shoulder)

  • 27702: Arthroplasty, ankle; with implant (total ankle) and their corresponding anesthesia codes

  • 00630: Anesthesia for procedures in lumbar region; not otherwise specified

  • 00670: Anesthesia for extensive spine and spinal cord procedures (e.g., spinal instrumentation or vascular procedures)

  • 01638: Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement

  • 01486: Anesthesia for open procedures on bones of lower leg, ankle and foot; total ankle replacement.

"Because we proposed to eliminate the IPO list entirely, the removed procedures were not assessed against our long-standing criteria for removal," CMS said in a Nov. 2 news release. "As medical practice continues to develop, we believed that the difference between the need for inpatient care and the appropriateness of outpatient care has become less distinct for many services."

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