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sxcoder05

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Topeka, KS
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Has anyone received payment for implants (L8699) or bone grafts (C1762) billed in an ASC? They denying the C1762 stating bundle or package and not separately payable. The reimbursement for the procedure does not cover the cost of the Allograft.
 
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Have you read their ASC Payment Policy effective 6/30/2020? It is here: https://www.dol.gov/sites/dolgov/fi...ambulatory_surgery_centers_payment_policy.pdf

That will direct you to other documents that you will need to review, including ASC Allowable Procedures. You can find all of those documents here: https://www.dol.gov/agencies/owcp/regs/feeschedule/fee/feeJune302020/view

C1762 and L8699 are on the list of bundled items, here: https://www.dol.gov/sites/dolgov/fi...ective_january_1_2020_asc_pymt_group_tab6.pdf

What all this means is that the ASC may decide not to do those procedures for DOL, and the patient will need to have it in a hospital or elsewhere.
 
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