mwmyers80
New
Good afternoon - I work for a Med Advantage plan and we follow Medicare billing rules. We started denying ASC claims submitted on an institutional claim form for incorrect claim type and are receiving feedback from certain providers that Medicare pays their ASC claims when submitted on the CMS-1450.
It has always been my understanding that ASCs bill on the CMS-1500, even when they are hospital owned but participating with Medicare as an ASC. I suspect that these are actually provider-based HOPDs that we have contracted with as ASCs but I'm hoping to get some feedback on the collective experience here.
Does Medicare, in fact, accept institutional claims with TOB 0831-0839?
It has always been my understanding that ASCs bill on the CMS-1500, even when they are hospital owned but participating with Medicare as an ASC. I suspect that these are actually provider-based HOPDs that we have contracted with as ASCs but I'm hoping to get some feedback on the collective experience here.
Does Medicare, in fact, accept institutional claims with TOB 0831-0839?