Page 2 of 2 FirstFirst 12
Results 11 to 20 of 20

Thread: fluoroscopy in ASCs

  1. #11
    Join Date
    Apr 2007
    Location
    Augusta chapter
    Posts
    17

    Default

    Promo: Code Books
    I don't know for sure, but it seems to me that if the ASC owns the equipment and read them, there would be no need for a modifier except the SG for ASG for Medicare. We get paid for them. I would appreciate any input.

  2. #12
    Join Date
    Apr 2007
    Location
    Palm Beach
    Posts
    69

    Default

    Quote Originally Posted by sdyches View Post
    I don't know for sure, but it seems to me that if the ASC owns the equipment and read them, there would be no need for a modifier except the SG for ASG for Medicare. We get paid for them. I would appreciate any input.
    sdyches - I am curious as to what state your facility is in that you are getting reimbursed for the fluoro and what insurance companies are reimbursing you and how much. Also, does your ASC facility have a physician employed there that does the reading of the fluoro? Your facility does not pay the physician for his service, you can not bill for the professional component and would therefore need to have the TC modifier on your bill for the fluoro.

  3. #13

    Default Flouro

    Our facility does not own the equipment. We have a tech that comes over from an imaging center next door and she operates the equipment while the surgeon does the procedure. In this case, should I be billing the flouroscopy with the TC modifier? Please help!!!

  4. #14

    Talking Just a thought

    I bill for my GI doctors and they also have their own ASC, which I also bill for. If fluroscopy is used, I bill the ASC with TC modifier and the physician porition with the 26 modifier. They way it works for us is the ASC owns the machine not the physician. The ASC and the physician are separate, different tax id's and everything. My doctor's have different provider numbers for the ASC than they do for their office. This is different than if done in the office. Yes there you could bill without modifiers because physician and technical are billed under the same tax id #/provider #. Our insurance's deny it as global to the procedure (CO97), mainly BC of AL denies but there are others

    Quote Originally Posted by cconroycpch View Post
    If your physician owns the equipment and uses it during procedures, you do not use any modifier. This would mean that you are billing globally (for the technical and professional components). You also state that most insurances do not pay for it. What is their denial reason? Are you being denied for both the professional and technical components? What insurance companies are denying?

  5. #15

    Default

    I am not positive, but it shoulds like the tech is doing the TC portion. Is the doctor reading anything, etc that maybe a 26 modifier could be used. Do you bill for the facility and physician. For the facility, you may not be able to bill anything but for the physician bill the 26 modifier. See my other post within this thread, I dont know if this helps or not.

    Quote Originally Posted by acuaria76 View Post
    Our facility does not own the equipment. We have a tech that comes over from an imaging center next door and she operates the equipment while the surgeon does the procedure. In this case, should I be billing the flouroscopy with the TC modifier? Please help!!!

  6. #16

    Default ascbiller

    Does anyone know when billing for a 62290/ 62291 do you bill for the epidurogram(72285/72295) per level or just once, and also for radiofrequencies do you bill the fluoroscopy per level or just once? Please help!!!

  7. #17

    Default

    72285 72295 per level
    fluoroscopy only once

    Quote Originally Posted by dawnee View Post
    Does anyone know when billing for a 62290/ 62291 do you bill for the epidurogram(72285/72295) per level or just once, and also for radiofrequencies do you bill the fluoroscopy per level or just once? Please help!!!

  8. #18
    Join Date
    Apr 2007
    Posts
    51

    Default

    Quote Originally Posted by tcraig View Post
    I have another question regarging fluro in an asc. We are a pain clinic. We do one surgical session, and I bill on fluro with a TC modifier. I was recently audited by an outside coding person who told me I needed to bill a fluro with every injection we did, with a 59 modifier. Any feedback?
    Sounds like that auditor needs to go back to school! You only bill it once unless multiple sites are being injected (example, dr injects C2-3 & also L4-L5 in the same session...you can bill a 2nd flouro with a TC 59( modifier). If multiple injections are performed in one region (example Lumbar L1-2 L3-4 L4-5) you can only bill it once.
    Last edited by gared111; 03-27-2008 at 02:13 PM.

  9. #19
    Join Date
    Apr 2007
    Location
    Central Arkansas
    Posts
    17

    Default

    You can't append the modifier -26 and TC for the same physican on the same date. If you own the equipement and the same doc reads the report you would use the global billing code which is not modifiers should be appended for the global billing.

    I have seen claims come in that some people will bill it on a different line item. Some even have one Line item 99999-26
    99999-TC-59
    This will not get paid EVER or at least not by my company.

    sdyches you are correct if both TC and -26.

  10. #20
    Join Date
    Apr 2007
    Posts
    14

    Wink Radiology in the ASC

    Does anyone bill regular x-ray codes in their ASC?? Not just 76000? I'm wondering what the guidelines are now that Medicare allows some radiology codes to be billed in an ASC. i have a case where the patient had a great toe fracture and surgeon says, "we brought in a mini C-arm and took AP and lateral views of the great toe and note that we were in bone (for pinning) and that we did not appear to be in the joint and our reduction was adequate." Is this enough to bill for 73660? Haven't done this before so want to make sure I know what I'm doing..... Thanks all!!!

Page 2 of 2 FirstFirst 12

Similar Threads

  1. Billing L codes and ASCs
    By Bethy4444 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 04-18-2014, 02:30 PM
  2. Can ASCs bill for pathology
    By BFAITHFUL in forum Outpatient Facilities
    Replies: 0
    Last Post: 03-17-2014, 03:04 PM
  3. Diagnoses for ASCs
    By acodingangel in forum Outpatient Facilities
    Replies: 1
    Last Post: 08-10-2010, 08:49 AM
  4. ASCs and Medi-Cal (CA Medicaid) billing
    By rgrimes in forum Outpatient Facilities
    Replies: 0
    Last Post: 01-19-2010, 04:46 PM
  5. ICD-10 and ASCs
    By carriep9829 in forum ICD-10
    Replies: 0
    Last Post: 10-23-2009, 06:33 AM

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?

Login

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.