Fluoro in ASC

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I have just switched from one pain practice to another and where I come from our physician's had ASC priviliges and so when we billed to Medicare we billed with fluoro, if the procedure was not inclusive. Now, I am trying to get the physician's at my new job to bill for the fluoro but they are convinced that Medicare will not pay. I do not recall this, can anyone help me out?
 

dwaldman

True Blue
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77003 has an N1 ASC payment indicator. N1 states the service is packaged into payment of another procedure. Thus for the ASC facility fee, 62310-62311 would include payment for the technical portion of the fluroscopy.
 

chasarmil

Networker
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We bill for fluoro's if not included and I have not heard that we are not getting paid for them.
 

dwaldman

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Addendum BB -- Final ASC Covered Ancillary Services Integral to Covered Surgical Procedures for CY 2012 (Including Ancillary Services for Which Payment is Packaged)

77003 Fluoroguide for spine inject N1

N1 Packaged service/item; no separate payment made.


Maybe for non-Medicare carriers, you are receiving ASC facility technical portion but as seen above for Medicare, there would not be separate payment for 77003-TC.
 

rjrine

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rjrine

You can bill 77003 on the professional side w/a 26 modifier if the code allows.
 
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