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Struggling with ASC coding & billing guidelines

  1. #1
    Default Struggling with ASC coding & billing guidelines
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    Pardon me if these questions have been answered in previous threads
    I'm struggling with ASC coding & billing guidelines
    Some of my questions include:
    1. Are Supplies billable if so which ones? My physician is billing A4550 & 99070 on same claim.
    2. Are drugs billable? To be specific J7050, J7070 (actually this is normal saline & D--W) and an infusion code has been billed CPT 96360
    3. ECG- 93042, pulse oximetry - 94760 have also been billed on claim? Can this be billed separately?? Anesthesia was provided for EGD w/biopsy 43239 & polyp removal via snare 43251.
    4. Is a recovery room charge justified X2??

    To me this seems like serious unbundling.... Also kindly direct me to any websites or recommended books that may be of help.

  2. #2
    Lightbulb It depends...
    It depends on your contracts. We have contracts that allow us to bill separately for supplies over $50. As you know, dilators adn gold probes are well over $50.

    Medicare is allowing some of the drugs to be billed separately like Zofran and Glucagon. Commercial carriers USUALLY follow Medicare rules.

    The real trick for me is finding good codes for the supplies. The codes the supply company gave me were discontinued in 2005.

    Good Luck!

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