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.
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Saturday, April 30, 2016
ASC surgical procedure components
Components of a Procedure
There are three (3) primary components in the total cost of performing a surgical procedure in an ASC:
• Professional Fee(s)
• : The cost of professional services furnished by physicians and other recognized health care practitioners for performing the procedure;
Facility Fee(s)
• : The cost of facility services furnished by the ASC facility where the procedure is performed (for example, surgical supplies, equipment and nursing services); and Surgical Implant Fee(s): The cost of the Surgical Implant(s) which includes the cost of the Surgical Implant(s), the Associated Disposable Instrumentation required for implantation of the device when received and included on the acquisition invoice for the Surgical Implant(s), and shipping & handling costs.
Reimbursement Components
Professional Fee(s) are billed by the health care provider according to the Florida Workers’ Compensation Health Care Provider Reimbursement Manual and reimbursed to the health care provider(s).
Facility Fee(s) are billed by the ASC and reimbursed to the ASC according to the guidelines of this Manual.
Surgical Implant Fee(s) are billed by the ASC and reimbursed to the ASC according to the guidelines for Surgical Implant(s) in this Manual.
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