ASC Coding 101


Albany, GA
Best answers
We are opening an ASC in a couple of weeks and I have been asked to tackle the facilty coding temporarily until off and running. This is new to me as I have only coded for professinal services. Does anyone have any advice, information, cheatsheets etc..... Anything is greatly appreciated.

If you would care to share what services will be offered in the ASC, that would provide some information that could allow to make some suggestions on resources. Although I won't have resources for all the specialties you'll probably be focussing on, things like IR, Cardiac Suites and a few ambultory surgeries I might have info. to share.
Have you ever considered using a billing service to handle all of the coding and billing for you? If interested our sister company is an ASC specific billing service. Contact Scott Winn, VP @ 800-865-2490, ext. 104.

I'd be happy to ask Mr. Plummer the president to help steer you in the right direction and possibly give you some useful information. Anything to help.
I think for what you're doing the CMS or FI carrier manual should be sufficient. Of course, consulting third-party payers outright might also afford you the chance the set up some payer-specific coding standards (in your existing billing software).

For ASC work you're doing (from a coding standpoint), the assignment will not be reported all that differently from the professional. I'm sure you're aware of the SG Modifier in HCPCs . . . so, as long as you employ the payer standards, CPT Assistant and maybe the specialty physician practice group recommendations, I can't imagine you're going to have a difficult time with any of it.

Ingenix has some terrific resources available per specialty and I'd highly recommend those for use. They may also lead you in a direction with any specific questions you develop.

Just remember that the facility (ASC) charges are for the technical component and set your billing/coding up accordingly: are drugs/supplies separately billable/reportable from the service; are physician extenders billable/reportable/pay-able in this setting (per carrier); are there different codes for supply devices applied during surgery; any new CCI Edits for the services you're furnishing?

These suggestions probably seem a bit on the basic side, but keep in mind this forum doesn't afford a different venue.

Hope my recommendations start the brain-storming process for you. Best of luck to you.
Asc 101

I have been an ASC coder for 7 years- if you have any questions, please feel free to contact me- 203-288-2555

Donna SanGiovanni CPC, CHI
Founder/President Hamden,CT Chapter 20307
Thank you all for responses. My head is spinning. Our first surgery, provided we pass inspection, is scheduled for June 6th. As for now, I will only be responsible for coding the charges for the surgical center. They will do the billing. Basically I have to familiarize myself with the technical/facility coding aspect as well as modifiers etc.... Hey, what's life without a challenge.

Donna, I may take you up on your offer. I appreciate any and all help.

Have a Blessed Day !!! ;)
May I also suggest you check out (federated amb surgicenters assoc). they also hold periodic ASC workshops, across the U.S. You may want to keep a close eye on CMS guidelines on ASC's (as they change from time to time) ASC's place of service is 24, and remember that good old modifier SG! You had mentioned ortho coding would be the speciality? Ingenix has good tools, but also check out the coding tools that medical management institute offers, as they too have an orthopedic coding book thats helpful as well. Try to find an ASC seminar in your area, I have always found them very imformative, plus they will give you coding/billing materials.
thanks, Connie
Asc 101

I am also a new biller/coder for a freestanding Ambulatory Surgery Center. We do mostly cataracts, carpal tunnel, ENT, ortho cases, etc. I have lots of questions but will start with one. How do you bill for implants? What is considered an implant (screws, wires, etc)? Are there any boot camps or seminars out there for Ambulatory Surgery Centers. Donna from Hamden, CT may I also call you or would you want to share your email address? I guess that was more than one question wasn't it. Hope you all have a great day! Lori
I too am new in ASC coding. I have lots of questions....IMPLANTS are killing me...any help would be great!!
ASC Coding

To take the load off Donna, I have also been doing ASC coding for 5+ years, I'll be happy to answer questions as well. I would rather not post my telephone # here, but you are welcome to e-mail me and I'll provide a prompt response.

ASC coding

It's great working at an ASC with multi specialties!! I've learned quite a bit working here for just little over a year.