Results 1 to 5 of 5

Thread: Infusions in ASC's

  1. #1
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Question Infusions in ASC's

    Promo: Code Books
    Reaching out for some help here. Administration wants me to find documentation that infusions cannot be done in an ASC for Medicare and also non-Medicare. (ie remicade infusuions) I am certain this is true, but I don't know where to find it without spending an entire day searching. If anyone has any information or links I will be forever indebted!!
    Lisa Bledsoe, CPC, CPMA

  2. #2

    Default Asc infusion

    It appears that neither chemotherapy nor infusion services have ever been allowed in an ambulatory surgery center setting for Medicare. The Claims Processing Manual, chapter 14, section 10.1 describes “An ASC for Medicare purposes is a distinct entity that operates exclusively for the purpose of furnishing outpatient surgical services to patients.”


    Infusion and chemotherapy do not qualify as “surgical services” according to this description. The codes for these services are not included on the list of covered surgical procedures.

    The complete lists of ASC covered surgical procedures and ASC covered ancillary services, the applicable payment indicators, payment rates for each covered surgical procedure and ancillary service before adjustments for regional wage variations, the wage adjusted payment rates, and wage indices are available on the CMS Web site at: http://www.cms.hhs.gov/ASCpayment/.

    pasted from Code correct
    hope this helps
    LG CPC,CASCC

  3. #3
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Talking

    Thank you. I spent a good portion of my day yesterday researching this to find the documentation that the powers-that-be requested (which I did find). Funny, they made an "attempt" but after 10 minutes they got lost on the CMS website and couldn't find a way out...lol.
    Lisa Bledsoe, CPC, CPMA

  4. #4

    Default

    We ran into this same situation with Remicade infusions. We now turn a couple rooms in the office into an infusion center a couple days a week. instead of the ASC. We can't bill a facility fee but it is still reimbursed well above the expenses and is very convenient and well received by the patients. Just a heads up, the billing and follow up on benefits is a nightmare though. Slow to pay so we have a lot of revenue tied up in meds until the payers finish running us through the ringer asking for notes etc. despite getting preauth.

  5. #5
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Default

    I think that is what they are looking into doing also. Thanks for the info.
    Lisa Bledsoe, CPC, CPMA

Similar Threads

  1. ASC accreditation - opening up a ASC
    By 574coding in forum Outpatient Facilities
    Replies: 2
    Last Post: 11-30-2015, 09:52 AM
  2. infusions
    By alices in forum Emergency Department
    Replies: 2
    Last Post: 01-06-2012, 05:55 AM
  3. ASC IV Infusions
    By cdherbold in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-06-2010, 11:15 AM
  4. ASC conference.....ASC low cost or free webinars?
    By mad_one80 in forum Outpatient Facilities
    Replies: 5
    Last Post: 07-27-2009, 10:36 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?

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.