Have any ASC coders/billers encounterd two surgeons working simultaneously or in sequence on a patient performing, two different services under one anesthetic setting? Example: ENT physician and pediatric dentist each performing separate surgeries on a child during the same anesthetic session.
If your ASC facility encountered this scenerio are these services billed out on two claim forms without a modifier? I believe appending modifier 59 may be inappropriate as Modifier 59 description states: "not ordinarily encountered or performed on the same day by the same individual".
If your facility has billed the two procedures performed by separate surgeons for the same date of service, did the facility get reimbursed for both procedures? Were the reimbursements full or partial? Are you finding reimbursement differs payor to payor?
Thanks in advance for your insight!
- Medical Coding
- Medical Billing
- Practice Management
- Exam Preparation
- Other Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Software / Digital
- Code Lookup (AAPC Coder)
- Virtual Coding Experience (Practicode)
- E/M Analyzer
- CPT RVU Calculator
- Health Plan Search (Provider Policies)
- Log In / Join