atheri992
Contributor
For those that bill/code for an ASC (Ambulatory Surgical Center), we have insurances that will only pay for the first procedure billed so even if we perform 4 different procedures and list all CPT codes individually with applicable modifiers, they still pay for the primary one. We don't get a 50% reduction on the second, 25% on the others. JUST the first CPT listed. Do you/would you add in the implant costs and reduction price of the other procedures and roll that into the one CPT line items to bill for? The policy says they'll pay 80% of billed charges and also says they only pay for one procedure code. How else would we bill and not lose an exorbitant amount of money?? I appreciate any feedback!
Last edited: