Wiki Fluoro in ASC

[mz1dynasty]

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]

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]

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

 

[dwaldman]

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]

rjrine

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