Medical Billing and Coding Resources
ASC billing is a combination of hospital and physician billing. Although ASCs use CPT and HCPCS Level II codes to bill most of their services (as do physicians), some payers will allow an ASC to bill ICD-9-CM procedure codes (like a hospital). Some payers even base implant reimbursement on revenue code classification. It’s important to use the proper form when submitting claims. Medicare pays for ASC services under Part B and requires the CMS-1500 claim form.
Billing Basics for ASC An ASC is defined as an entity that operates exclusively for furnishing outpatient surgical services to patients. To receive coverage of and payment for its services under this provision, a facility must be certified as meeting the requirements for an ASC and enter into a written agreement with CMS. Let’s discuss […]
Coverage for Non-ASC Facility Services Physicians’ Services – This category includes most covered services performed in ASCs which are not considered ASC services. Physicians who furnish services in ASCs may bill for and receive separate payment under Part B. Physicians’ services include the services of anesthesiologists administering or supervising the administration of anesthesia to beneficiaries […]
