Wiki HELP!!! Need advice on Dental Billing for ASC

[NKenner]

I work for a new ASC and they are interested in adding Dental procedures, from what I gather ASCs are not able to bill dental codes. Is this correct? Can I bill only procedure code 41899 to insurances? How does that work for reimbursements? Is it worth doing dental?

 

[tfog]

dental & ASC's

Hi,
The ASC bills for the use of the facility. The surgeon's bill for the procedure(s) they performed.
I'm not familiar with ASC's billing process, so correct me if I'm wrong.
The ASC would not be able to bill the dental codes, (1) because the facility is not doing the procedure, the surgeon is. (2) Another reason is that many times the surgeon's are doing a medical procedure and must bill with CPT codes instead of CDT codes.
CPT code 41899 is the correct cross code from dental to medical for extractions. But why is the facility billing for a procedure that the surgeon does? They are two separate claims.
Reimbursement for the surgeon's is around 80% UCR. I would guess that the facility would have a similiar or better amount.
Most dental/OMS surgeries that are sent to an ASC are in the $2-$10,000 range.
Contact me if I can help. tfog@triad.rr.com
Beth