Wiki Billing for ASC charges not on Medicare fee schedule

kris32821

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Hi all,

I have 8 pain management ASC CPT codes that are not on the Medicare fee schedule (MAC is Palmetto). It has been suggested that we drop these charges down to $0 and not bill them to Medicare. I suggested still billing them to Medicare to get the denial, and potentially billing the patient for the non covered charges as long as we have an ABN and they are aware. Any advice on this? I dont feel comfortable not billing Medicare for a documented procedure.
 
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