Wiki Supplier billing ortho implants/hardware in an ASC setting????? HELP

[gr8gal61]

I've had a company contact me regarding billing for the hardware & possible implants for orthopedic procedures being performed at an ASC. I understand that many of these procedures, if not all (from what I've read) are bundled into the procedure. I also read you must have a negotiated contract with the insurance payers in order to invoice them directly? I just know that several of the surgeons have asked him to bill the implants/hardware so that their revenue is where they want to be or need to be or???

I just need some guidance and assistance if anyone has had this experience.

Thanks

 

[jennburgel]

Implants at an ASC

Hi
I bill for an ASC and we bill for the implants that are used for the patients such as screws, anchors, pumps, IPG batteries and leads. These implants are included on our claim by the use of the HCPCS codes assigned ie: screws and anchors are coded to C1713. The first thing you need to check is if you contracts with your payers include payment for implants ( carveouts ). If you are not contracted to be paid than you as the ASC cannot bill for them. W/C carriers re different and you should be billing for them and including an implant vendor invoice with your claim and op report. If you are contracted for reimbursement for your commercial carriers just send the claim elec as usual. If they require anything they wil ask for it. I hope this helps