Ambulatory surgical center billing code guidelines and how to get payment from insurance. ASC denial, CPT CODES , Authorization and referral Guide. Multiple procedure, Surgical procedure tips. What to get the correct reimbursement in ASC billing setup. SNF billing Guide, tips to use correct CPT AND POS.
Friday, July 9, 2010
Definitions of covered ASC facility services include:
�� Administrative, Recordkeeping and Housekeeping Items and Services
These include the general administrative functions necessary to run the facility e.g., scheduling, cleaning, utilities, and rent.
�� Anesthesia Materials
These include the anesthetic itself, and any materials, whether disposable or re-usable, necessary for its administration.
�� Blood, Blood Plasma, Platelets, etc., Except Those to Which Blood Deductible Applies
While covered procedures are limited to those not expected to result in extensive loss of
blood, in some cases, blood or blood products are required. Usually the blood deductible
results in no expenses for blood or blood products being included under this provision.
However, where there is a need for blood or blood products beyond the deductible, they are
considered ASC facility services and no separate charge is permitted to the beneficiary or the
program.
�� Diagnostic or Therapeutic Items and Services
These are items and services furnished by ASC staff in connection with covered surgical procedures. Many ASCs perform diagnostic tests prior to surgery that are generally included
in the facility charges, such as urinalysis, blood hemoglobin, hematocrit levels, etc. To the
extent that such simple tests are included in the ASC’s facility charges, they are considered
facility services. However, under the Medicare program, diagnostic tests are not covered in
laboratories independent of a physician’s office, rural health clinic, or hospital unless the
laboratories meet the regulatory requirements for the conditions for coverage of services of
independent laboratories. Therefore, diagnostic tests performed by the ASC other than those
generally included in the facility’s charge are not covered under Part B and are not to be
billed as diagnostic tests. If the ASC has its laboratory certified, the laboratory itself may bill
for the tests performed.
The ASC may make arrangements with an independent laboratory or other laboratory, such
as a hospital laboratory, to perform diagnostic tests it requires prior to surgery. In general,
however, the necessary laboratory tests are done outside the ASC prior to scheduling of
surgery, since the test results often determine whether the beneficiary should have the
surgery done on an outpatient basis in the first place.
�� Drugs, Biologicals, Surgical Dressings, Supplies, Splints, Casts, Appliances, and
Equipment
This category includes all supplies and equipment commonly furnished by the ASC in
connection with surgical procedures. See the following paragraphs for certain exceptions.
Drugs and biologicals are limited to those which cannot be self-administered.
Labels:
ASC billing basic,
ASC covered services
Subscribe to:
Post Comments (Atom)
Popular Posts
-
Revenue Code Revenue codes are 3-digit numbers that are used on hospital bills to tell the insurance companies either where the patient wa...
-
Procedure code and Description CPT/HCPCS Codes G9685 Evaluation and management of a beneficiary's acute change in condition in a nu...
-
Place of Service Codes Place of service codes do not apply when filing the UB-04 claim form. Only type of Bill has been used in UB 04 FORM...
-
CPT CODE DESCRIPTION OF SERVICE FEE 65710 KERATOPLASTY (CORN. TRANS), LAMELLAR 677.77 65730 KERATOPLASTY, PENETRATING (NON-AHAKIA) 754....
-
HCPCS CODES: Group 1 Codes: A4636 REPLACEMENT, HANDGRIP, CANE, CRUTCH, OR WALKER, EACH A4637 REPLACEMENT, TIP, CANE, CRUTCH, WALKE...
-
CPT CODE 99070 - Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and ...
-
Procedure code and Description 99307 NURSING FAC CARE SUBSEQ $43.16 - $47.96 - 99308 NURSING FAC CARE SUBSEQ $66.72 - $74.13 - 99309 NUR...
-
Effective for dates of service on or after January 1, 2009 for allowed ASC claims, if modifier = TC, contractors must ensure that either: ...
-
What Is Health IT? The term “health information technology” (health IT) refers to the electronic systems health care professional...
-
Revenue Code List 0610 to 0900 REVENUE CODE DESCRIPTION 0610 MRI 0611 MRI-BRAIN 06...
No comments:
Post a Comment