Wiki Billing Supplies for ASC

[mattamyc]

Can anyone recommend a website, class, or book to help decide what supplies can be billed for an ASC? I know everything is included for Medicare but commercial carriers can be billed for special supplies/implants. I am very confused as far as epidural needles, catheters, blades, things that are not implanted and used mostly for pain mgmt and podiatry procedures.

Thanks,

Amy

 

[Walker22]

It's going to be different for each insurance. The best thing to do is bill for what was used (and documented, don't forget!) and take the write-off for the items that get bundled. Eventually you will figure out the things that always get bundled and you can stop billing for them.

 

[gared111]

I worked in an ASC for years that did both pain management & podiatry. We never billed for the blades, epidural needles, catheters & related surgical supplies, those were bundled. We could however bill separately to all our private ins carriers for actual implants like screws, plates, joints. Some required we just bill the actual cost of the implant & attach an invoice to the claim, others we billed our normal rate of 150% of actual cost & then put the description in box 19. For the private carriers payment for implants was a case by case basis, based on the wording in our contracts.

We did have one exception on supplies. We billed separately for something associated with the IDET procedures for pain management. I think it was either the needle or catheter, I can't remember which it was but our actual cost of this supply was close to $700.00 with reimbursement for the entire procedure only being about $600. I've been out of pain management billing for a good 18 months now but when I did it those IDET's were still being considered investigational so we could just have all pt's sign ABN's & agree to pay for that $700 supply before we would perform the procedure (& of course collect that pmt up front!). If it's no longer investigational, it may be a different situation now with bundling of that catheter/needle.

Long winded I know, but basically it's determined on a carrier by carrier basis & unless there is wording in your contract that specifically states they will pay implants separately you're going to have a had time getting the insurances to unbundle them.

Good luck!