Wiki Surgeon performing at an hospital based ASC instead of the hospital

[FL_Coder]

I have a physician the performs surgeries at the hospital and at the hospital based ASC. I code his surgeries and noticed that when he goes to the hospital based ASC they code the surgery under his name also. This is causing a bundling edit, should we both be coding/billing 55920 ? Should my billing area reflect our specialty and the location and hospital reflect ASC ?

 

[SharonCollachi]

when he goes to the hospital based ASC they code the surgery under his name also.

I'm not clear on what this means. Do you mean they are billing under his name and not under the name of the ASC?

 

[csperoni]

I don't bill for ASC, but my understanding is the ASC bills the facility portion (I think modifier SG??). And the surgeon bills his professional services.
We have been doing procedures in an ASC for years, and I don't think I've ever seen a bundling edit from a carrier.

 

[FL_Coder]

I'm not clear on what this means. Do you mean they are billing under his name and not under the name of the ASC?

Looking at the invoice it shows the MD's name, the billing area is OSC and the hospital and location are ASC, with the surgery code 55920. I'm not sure if this is the way it should be coded for the ASC as I do not have any experience coding for ASC's. I just want to be sure that I am coding everything that I should be for the MD. Thanks for your reply

 

[FL_Coder]

I don't bill for ASC, but my understanding is the ASC bills the facility portion (I think modifier SG??). And the surgeon bills his professional services.
We have been doing procedures in an ASC for years, and I don't think I've ever seen a bundling edit from a carrier.

Thanks