isa709@yahoo.com

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Does anyone know where i can find all the procedures that can be done in an OBL (Office Based Labs), Medicare reimbursement for them as well?
Any insight would be greatly appreciated.
 

isa709@yahoo.com

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For labs, my understanding is that it would be based on your CLIA certificate. The Medicare fee schedule is available here https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched or if you subscribe to any online tool (like Codify, not a plug, just a comment :).)
Hi there, :) OBL are not labs. Office Base Labs or Office-based Intervention Lab or Outpatient Interventional Suite are Minimally invasive procedures done in an office or freestanding facility detached from a hospital. Our doctor is trying to start one, and we need to know what are all the procedures that would qualify under these.... but i cant find anything really... :(
 

csperoni

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OOOOOHH. I've heard of OBS for office based surgery, but never OBL. Maybe it's not something common, or just not common in my area. If it is anything like OBS, my advice is it is not usually worth the additional reimbursement to follow all the required regs. At least that was my personal experience. We about broke even, but did it for the convenience of the provider. For OBS, the fee schedule is simply the fee schedule for non-facility. I hope someone with OBL experience will chime in for you. Good luck!
 

SharonCollachi

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I agree with csperoni.

Adding up all of our costs (paying the c-arm guy for the day for himself and his equipment, paying the RN to do IV's, plus supplies) - if we scheduled say, 8 procedures, and 2-3 or so people either didn't show up, or ate when they weren't supposed to, or had a fever, then we lost money for the day.

We did spinal blocks, epidurals, those sorts of things.
 

isa709@yahoo.com

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I agree with csperoni.

Adding up all of our costs (paying the c-arm guy for the day for himself and his equipment, paying the RN to do IV's, plus supplies) - if we scheduled say, 8 procedures, and 2-3 or so people either didn't show up, or ate when they weren't supposed to, or had a fever, then we lost money for the day.

We did spinal blocks, epidurals, those sorts of things.
Yessss thats exactly what our Group of Doctors do. Spinal blocks, epidurals, Spinal stimulators, stem cell injections etc...(pain management doctors/anesthesiologist). I was sent on this quest to look for OBL allowable procedures but perhaps is same as OBS?. Do you know where i can find a list of all the procedures that are allowed to be done in an OBS? thank you so much!
 

isa709@yahoo.com

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OOOOOHH. I've heard of OBS for office based surgery, but never OBL. Maybe it's not something common, or just not common in my area. If it is anything like OBS, my advice is it is not usually worth the additional reimbursement to follow all the required regs. At least that was my personal experience. We about broke even, but did it for the convenience of the provider. For OBS, the fee schedule is simply the fee schedule for non-facility. I hope someone with OBL experience will chime in for you. Good luck!
You might be right... perhaps they mean the same thing! ok so as far as the reimbursement, then I should just look into the PFS ? But im confused, since I'm billing for the professional component and the technical one, shouldn't the rates be higher than the regular Physician Fee Schedule? 😣
 

SharonCollachi

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You might be right... perhaps they mean the same thing! ok so as far as the reimbursement, then I should just look into the PFS ? But im confused, since I'm billing for the professional component and the technical one, shouldn't the rates be higher than the regular Physician Fee Schedule? 😣
You're already getting higher rates than you would get in an ASC or hospital. When it's done in a facility, the facility gets a fee, and the doctor gets a lower fee (because he has no overhead) than when done in an office. When you're billing in the office, you have the overhead, so the reimbursement is higher. So you bill the procedure, and you bill the moderate sedation fees, and you bill the drugs you use, and you bill the imaging if it's not already included in the procedure.

What procedures you can do will depend on accepted medical practice, and what your doctor feels comfortable with doing under moderate sedation. Some doctors won't do an SCS permanent implant outside of an ASC; some will do it in an office with a procedure room (with real-time imaging).

The commonly done procedures are all the types of spinal injections (blocks, epidurals, facets, etc.), joint injections, and spinal cord stim trials. We never did radiofrequency ablations, so I'm not familiar with the level of anesthesia needed for that.
 
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