Wiki Looking for ASC guidance for GYN Practice

[mccormickk]

Does anyone have experience with a practice owned ASC for GYN providers? Looking for a resource to speak with to see how billing/coding for owned ASC is performed?

 

[csperoni]

Does anyone have experience with a practice owned ASC for GYN providers? Looking for a resource to speak with to see how billing/coding for owned ASC is performed?

I don't have specific guidance, but rather some general advice and place to start.
1) This varies A LOT by state. In NY for example, the restrictions are significant about what can and cannot be considered an ASC. You must meet stringent guidelines that are basically impossible if it is not a free-standing facility, but rather a separate suite in the office. As a result, the surgical suite is considered an office location, and not a facility. Billing and coding is done like anything else performed in office with site of service differential.
2) This varies A LOT by payor. You should reach out to your payors to see if they will credential your location as a facility. Some may only consider your site a facility if you meet the guidelines for Medicare to consider you a facility. Even those that will allow as a facility, some want UB04 billing, some want CMS1500 billing.
As a result of the above, there is a lot of nuance containing complex compliance and legal information to digest. An attorney experienced in this area is highly recommended.
Good luck!