Wiki Help with ASC Surgical Implants

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Long Beach, CA
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I am having trouble getting surgical implants paid with workers comp, even when we bill with the invoice. They are stating that these are included in the global fee

I am including the implants on the initial UB04, do i need to bill them separately???

anyone having the same problem?
 
Many implants are bundled into ASC rates. Especially device intensive. its not always separately reimbursable so its really going to vary by payers especially workers comp which is usually handled differently in each state.
 
I have never had my implants be included globally if billed for the facility. I code 99070 with an IM modifier. If it is a disposable use DI modifier. I also bill for shipping cost which is an SH modifier. Also make sure you use the correct revenue code (278).
 
I realize this is an old thread.

But it doesn't appear that 99070 can be billed for the ASC.

To answer the original poster, I am also getting implants denied for being bundled into the EAPG payment. They are high-cost implants, so I am trying to figure out a way to get them reimbursed separately from Worker's Comp. Any ideas?
 
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