574coding
Guru
Hello,
We are having issues with our multiple surgical procedure performed at the same session reimbursement with Work comp. Our ASC facility is here in California. In the past, we would be reimbursed 100% of the listed value for the first code, 50% of the listed value for second, third, fourth codes. Our recent EOB's show payment of 100% of the listed value for the first code, 50% of the listed value for the second code and 25% of the listed value for third, 12.5% of the listed value fourth code.
I looked in the APC book, and searched on line to see if I could find anything in writing about the reimbursement tier / % of the reimbursement and have not been able to locate anything.
I know that in the OMFS on page 93 , they had the professional tier listed as100% major procedure, 50% second procedure, 25% third procedure.
Does anyone have any written information on how the ASC claims are processed in 2014 with work comp?
Thank you!
We are having issues with our multiple surgical procedure performed at the same session reimbursement with Work comp. Our ASC facility is here in California. In the past, we would be reimbursed 100% of the listed value for the first code, 50% of the listed value for second, third, fourth codes. Our recent EOB's show payment of 100% of the listed value for the first code, 50% of the listed value for the second code and 25% of the listed value for third, 12.5% of the listed value fourth code.
I looked in the APC book, and searched on line to see if I could find anything in writing about the reimbursement tier / % of the reimbursement and have not been able to locate anything.
I know that in the OMFS on page 93 , they had the professional tier listed as100% major procedure, 50% second procedure, 25% third procedure.
Does anyone have any written information on how the ASC claims are processed in 2014 with work comp?
Thank you!