Why Leading ASCs Treat Denial Management as an EBITDA Protection Strategy

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For many Ambulatory Surgery Centers (ASCs), denial management has traditionally been viewed as a back-office billing task. Claims were denied, staff corrected errors, appeals were submitted, and payments were eventually collected. In 2026, however, leading surgery centers are treating denial management very differently. They now view it as a direct EBITDA protection strategy that influences profitability, cash flow, valuation, and long-term growth. This shift is occurring because denial-related revenue loss extends far beyond unpaid claims. Every denied claim creates additional labor expense, delays cash flow, increases accounts receivable (AR), consumes management time, and reduces operating margin. When denial rates rise, EBITDA can decline even if surgical volume remains strong. As reimbursement pressure increases, more ASCs are investing in specialized ASC Billing Services , comprehensive medical billing services , advanced RCM services , and proactive Revenue Integrity programs ...
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Correct Use of Modifier 50 in ASC Billing

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Modifiers are two-digit symbols added to CPT procedure codes to signify the procedure has been altered in some way. Modifiers are accepted by Medicare and most other payers, however, using modifiers correctly can be confusing, since not all payers want modifiers used the same way. Medicare defines the ASC facility’s Global Period to be 24 hours from the time the first procedure begins – it is NOT 10 or 90 days like the physician’s Global Period might be. However, some payers other than Medicare might consider the Global Period to be 48 – 72 hours for ASC facilities. Some Modifiers are for use by physician practices only, some for use on facility claims only, and some are for use by both provider types. In this Blog, we have discussed the correct use of modifier 50 in ASC billing.

Not using Modifiers according to each payer’s specifications can cause unnecessary denials or cause claims to not pay properly. Certain Modifiers are for use because the patient had to return to the OR for another procedure the same day or close to the time another procedure was performed in your facility – which is referred to as the “Global Period” or “Postoperative Period.”

Modifier 50 in ASC Billing: Bilateral Procedures

For Bilateral procedures, use the -50 or -RT/-LT modifiers when an identical procedure is performed on both the Right and Left sides of the body. The policies payors have for the use of modifiers for reporting bilateral procedures can vary. Check with each payor for their preferred method of billing bilateral procedures.

Do not mix methods or modifier types. Never use the -RT/-LT Modifiers on the same code listed on the claim as one line item. Billing with one line item can only be done using the -50 Modifier (which is not accepted by Medicare). Do not mix the -50 Modifier with –RT or –LT Modifiers. Do not use Bilateral Modifiers on those CPT codes with verbiage describing procedures as “Bilateral” or “Unilateral or Bilateral”.

To know more about the Correct Usage of Modifier 50 in ASC Billing and Modifiers LT and RT for Bilateral Procedures, click here: https://bit.ly/40pqtKy Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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