Medical Billers and Coders

  Challenges of Ambulatory Surgical Centre Billing Ambulatory Surgical Centre billing and coding are completely different from the rest of medical specialties or the usual physician billing or even facility billing as they majorly are a combination of hospital and physician medical billing. Plus Ambulatory Surgical Centre billing involves specialties like orthopedics, pain management, bariatric surgery,  podiatry,  ophthalmology, obstetrics, gynecology, endoscopy, and dental. CMS and Medicare allow only certain surgical procedures can be done in ASC, which makes the billing and reimbursement from Insurance difficult with restrictions on out-of-network coverage. Frequent release of upgrades in coding guidelines and billing regulations can add up to the complexities involved in billing and coding for ASC. Sourcing and retaining highly experienced ASC billers and coders can be a pain point and outsourcing Ambulatory Surgical Centre billing could be the only solution. Benefits of Outsou

  Beginning January 1, 2008, the CMS publishes updates to the list of procedures for which an ASC may be paid each year. In addition, CMS publishes quarterly updates to the lists of covered surgical procedures and covered ancillary services to establish payment indicators and payment rates for newly created Level II HCPCS and Category III CPT Codes. Keep reading to learn ASC billing and coding. The complete lists of ASC-covered surgical procedures and ASC-covered ancillary services, the applicable payment indicators, payment rates for each covered surgical procedure and ancillary service before adjustments for regional wage variations, the wage-adjusted payment rates, and wage indices are accessible on the CMS Web site. To be paid under this provision, a facility must be certified as meeting the requirements for an ASC and must enter into a written agreement with CMS. ASCs must accept Medicare’s payment as payment in full for services with respect to those services defined as ASC se

  The basics of ASC Coding And Billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. ASCs use 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-10-CM procedure codes (like a hospital). Some payers even base implant reimbursement on revenue code classification. One of the most fundamental differences between billing for professional services and billing for ambulatory surgery center services is the concept of the global surgical package. The global package applies to the professional component of a surgical service that is performed when using a surgical CPT code. On the professional side, this typically encompasses a 90-day follow-up. In the  ASC billing  methodology, no such surgical package exists. Therefore, each time a