Results 1 to 4 of 4

asc surgery that results in subsequent admission

  1. Default asc surgery that results in subsequent admission
    Clearnace Sale
    How or who bills for services that are done in the ASC that results in admission?

  2. #2
    Louisville, KY
    That is dependent upon a number of factors.

    Generally, the surgery (if performed) is coded (by the ASC). The diagnoses would reflect the patient's reason for surgery is Primary and any other factors (including that of admission) as secondary. The 72 hour rule applies primarily to when/if the patient receives services from the same hospital (as subsequent admission) during that time. To my knowledge that does not affect services provided elsewhere.

    The hospital, on the other hand, would bill as Principal the reason for the admission and all services falling within the admission to discharge time frame under the DRG.

    Hope this helps.

  3. Default
    What I dont understand is per BCBS all services have to be billed by the Hospital, including the surgery. They are stating that it should all be billed on one claim.

  4. #4
    Is your ASC a freestanding facility? If so, the ASC bills for the surgical procedure done within your facility and the hospital bills for its services on their own bill.

Similar Threads

  1. Replies: 0
    Last Post: 04-10-2014, 03:07 PM
  2. Admission with Surgery
    By kathy a in forum Orthopaedics
    Replies: 0
    Last Post: 09-13-2013, 07:06 AM
  3. Replies: 1
    Last Post: 05-17-2012, 10:11 AM
  4. inpatient surgery and admission e & m
    By Shrina in forum E/M
    Replies: 1
    Last Post: 12-29-2011, 03:31 PM
  5. Admission after decision for surgery
    By Stacyharter98 in forum E/M
    Replies: 1
    Last Post: 09-29-2010, 03:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.