Reader Question: Freestanding Ambulatory Surgery Center

Question: At our freestanding ambulatory surgery center (ASC) can we bill items such as Bionics arrows and meniscal screws separately from the facility fee? The Federal Register indicates that surgical supplies are part of the facility fee. Are these arrows and screws considered supplies or implants?

Fran Liverman, CPC
Virginia Beach Ambulatory Surgery Center
Virginia Beach,Va.

Answer: You can bill for screws, drill bits, plates, etc., but reimbursement will depend on the carrier. Code A4649 (surgical supply; miscellaneous) should be used for the screws. HCPCS A4649 has a status code A, which is only reimbursed if you have a durable medical equipment fee schedule.

The revenue code for implants is 278. Facility charge masters require a revenue code so it will be summarized on the UB92. An implant such as a pin or screw will more than likely be reimbursed by an HMO if this is written into the contract.

- Published on 2001-02-01