Wiki ASC IMPLANT HELP

[ginad1979@gmail.com]

Hello, I am new to ASC coding and the facility I work with pays out of pocket for any implants/dme that the physician needs. When billing for the implants we have not been successful in getting reimbursed. Are we doing something wrong or are these costs bundled into the procedure codes? It's just these implants are so expensive and the reimbursement has been awful! Thank you so much for any assistance/advice you can offer.

 

[sls314]

Hello, I am new to ASC coding and the facility I work with pays out of pocket for any implants/dme that the physician needs. When billing for the implants we have not been successful in getting reimbursed. Are we doing something wrong or are these costs bundled into the procedure codes? It's just these implants are so expensive and the reimbursement has been awful! Thank you so much for any assistance/advice you can offer.

I would check your payer contracts. It depends on the language written into the contract for each payer.

The rate exhibit would mention whether there was a carve out for implants, and the contract should also define what is considered to be included in the procedure rate.