Fix ASC Billing Margins to Protect Surgical Revenue

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Fix ASC Billing Margins to Restore Financial Stability Ambulatory Surgery Centers (ASCs) are under increasing financial pressure. Rising supply costs, staffing challenges, payer reimbursement cuts, and complex billing rules are steadily shrinking profitability. When billing inefficiencies exist, even high surgical volume cannot protect ASC billing margins. Fixing ASC billing margins requires more than increasing case volume. It demands accurate coding, clean claims, payer compliance, and a disciplined revenue cycle strategy. Without these elements in place, revenue leakage becomes inevitable. Why ASC Billing Margins Are Declining ASC billing margins are declining across the U.S. healthcare system due to a combination of operational and reimbursement-related factors. Many of these issues remain hidden until cash flow is already impacted. Key contributors include: Underreported procedures and implants Incorrect CPT, HCPCS, and modifier usage Missed or delayed pre-authorizations ...

Know your DME HCPCS Codes



In DME medical billing, your DME coders require correct HCPCS codes along with correct modifiers that are used for providing more details about the equipment. If your medical coders are unable to use modifiers or not using them in the correct manner, then the claims may get denied by the insurance company. Some common DME modifiers include RR- rental, UE- purchase of used equipment, and NU- purchase of new equipment.

When a laboratory demand, request for DME is being filled, medical coders will be needed for ICD-10 codes for a patient’s diagnosis.

To use an appropriate HCPCS code for the DME item, many HCPCS codes need a modifier. Modifiers are used to provide more details about the DME item. e.g. The modifier might indicate to HMSA that an item is new, rented on a capped basis, or rented. For capped rentals, modifiers differentiate which month’s rental is being billed.

If your billers use these modifiers incorrectly then the claim will be rejected. To speed up this process of your claims, show the first-month rental by adding the appropriate modifier code and bill your claims in successive order. 


To get more information about DME HCPCS Codes click here: https://bit.ly/3rLoDUp. Get in touch with us at: info@medicalbillersandcoders.com/ 888-357-3226. 

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