Wiki ASC Coding/Billing

[consultingbykristin]

Hi,

It's been over 10 years since I've done ASC coding/billing so I need some help....

1. Code CPTs and ICD-9
2. Don't code medications as they are included, correct?
3. Do we submit revenue code for those medications? Or generic pharmacy?
4. If case was a pain procedure, do we submit for the fluoroscopy, epidurogram, any materials injected?


Am I missing anything vital?


Thanks to all who can and do respond!

 

[capricew]

Hi,

It's been over 10 years since I've done ASC coding/billing so I need some help....

1. Code CPTs and ICD-9
2. Don't code medications as they are included, correct?
3. Do we submit revenue code for those medications? Or generic pharmacy?
4. If case was a pain procedure, do we submit for the fluoroscopy, epidurogram, any materials injected?


Am I missing anything vital?


Thanks to all who can and do respond!

1. yes
2. correct
3. no- meds are not billed at all as it is incidental to the payment received for the procedure billed. But the meds should still be documented in the chart.
4. for pain procedures, fluoroscopy is inherent to most procedures nowadays. You can still bill it for 62310 or 62311 or joint injections when used. But that is pretty much it. If you are unsure when you can bill it, be sure to always check CCI edits as it will tell you when fluoro codes are bundled. You do however want to look at your contracts as most commercial carriers put right in the contract that all imaging services are included in the grouper payment and not separately payable. You also get to bill imaging when you perform discograms - if you do these at your facility. (Medicare does not pay for discograms at a facility as it is not on their list of approved procedures for an ASC).
Contrast materials are not separately reportable.

Good Luck!

 

[abs1821]

I'm finding when we bill 77003 with CESI or LESI that sometimes payers pay but other times they rebundle them (specifically MCR and Tricare...although some tricare are paying). I've used a 59 and TC mod on 77003 and when I bill the physician fees I just put a 26 mod on the fluro.