One source of truth

The 2026 CPT code set, released by the AMA in September 2025, added 288 new codes, deleted 84, and revised 46 — 418 total changes.¹ For ASCs specifically, CMS finalized a 2026 Hospital Outpatient and ASC Final Rule that added 276 procedures to the ASC Covered Procedures List and began a three-year phaseout of the inpatient-only list, with 285 primarily musculoskeletal procedures moving to the outpatient bucket in 2026.²

The migration to outpatient is accelerating, the codes underneath it are changing, and the payer rules governing both are not standardized. This is, to put it mildly, a hard environment to run a business office in.

In most ASCs, the institutional knowledge for "what do we need to schedule and authorize this case?" lives in three places: the surgeon's preference card, a coordinator's memory, and a binder of payer rules that may or may not be current. A 2020 study on surgical preference card standardization documented substantial variability in average cost per case across surgeons performing the same procedure; an industry survey widely cited in ASC operations literature found 80% of surgeons and 70% of perioperative nurses dissatisfied with the accuracy of their cards.^3,4

Now layer on payer fragmentation. Commercial payers, Medicare, and Medicaid each have different documentation requirements for the same CPT code. Medicare Advantage plans, which issued 52.8 million prior authorization determinations in 2024, add a layer of variability on top of fee-for-service Medicare.⁵ The same procedure can have meaningfully different scheduling, authorization, and documentation requirements depending on whose card the patient is carrying.

DataLily's Procedure Library is one canonical reference, structured by CPT code, with three configurable layers stacked on top. Once the library is configured for a surgeon, procedure, and payer combination, every case scheduled against that combination automatically inherits the right rules. The pre-op screening agent knows what to look for. The prior auth agent knows what to draft. The task management agent knows what to flag.

The procedure library is what makes the rest of Lily's agents specific to your center rather than generic. For a multi-surgeon, multi-specialty ASC, this is the difference between training every new coordinator on every surgeon's preferences and trusting that the system already knows.