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Wiki Calculating UCR

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GretchenC123

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I am doing an audit for my insurance company (3rd party liability for a personal injury) and the claimant had an outpatient lumbar discectomy/laminectomy one level. Do outpatient facilities get reimbursed for each line item on the bill or for a "procedure" cost like a package? The bill has some CPT codes for the supplies, surgery times, drugs, etc but not for all of them. I know this may seem like a real novice question, just looking for some insight so go easy on me. I am a nurse, not a professional biller. Thanks.
 
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