# ASC billing advice



## donnar (Dec 17, 2008)

I am fairly new to ASC facility billing,  our facility is looking into providing laporscopic inguinal hernia reapairs 49650.  Can we bill for supplies separately or are the supplies in conjuntion with the procedure.  Any advice will be helpful. Thanks


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## bethh05 (Jan 9, 2009)

The ASC I work uses C1781 for the mesh,if used. This is carrier driven as far as reimbursement.


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## eguerrero (Jan 9, 2009)

As bethieh stated above you can bill for the mesh and also I would suggest you review your carrier contracts to see how or if they will reimburse for the extra supplies.  If they are not specific I would suggest you have your contracting people go back and negotiate to have it added to the contract.  There are many supplies/implants that can be paid separately and are also very expensive and can hurt the ASC.  =)


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## mad_one80 (Jan 13, 2009)

it totally agree with eguerrero...the contracts are all carrier specific but very true that there are many supplies/implants that can be paid separately and are also very expensive and can hurt the ASC if we werent able to code/bill in additon the the procedure codes!


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## ckkohler (Jan 16, 2009)

*ASC Questions ...*

 Hi all!
I, too, am fairly new to the ASC billing process.  Actually, I have been in the medical billing business for 30 years - but, never worked with ASC; my present position - I don't really do any billing - but, I play a more administrative role in the ASC .. however, with my insurance industry background - I'm questioning whether the ASC billing is being done correctly.  Here are my questions:

1. what type of services are considered to be inclusive of the facility fee?  the people who do our billing breakout the fluorscopy and sedation charges .. my insurance head thinks this is wrong ... but, I'm not sure

2. does anyone know how to get training on correct ASC billing procedures?  Someone had previously directed me to some on-line Medicare information - but, I'm looking for the actual training or study materials in order to take the exam in May

Any help would be greatly appreciated!  Have a happy weekend, all!


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## mbort (Jan 16, 2009)

ckkohler said:


> Hi all!
> I, too, am fairly new to the ASC billing process.  Actually, I have been in the medical billing business for 30 years - but, never worked with ASC; my present position - I don't really do any billing - but, I play a more administrative role in the ASC .. however, with my insurance industry background - I'm questioning whether the ASC billing is being done correctly.  Here are my questions:
> 
> 1. what type of services are considered to be inclusive of the facility fee?  the people who do our billing breakout the fluorscopy and sedation charges .. my insurance head thinks this is wrong ... but, I'm not sure
> ...





Fluoroscopy/c-arm are seperately reportable in an ASC using the TC modifier for some cases.  It depends on the CCI edits as well.

Sedation...conscious sedation?  it is also reportable in some instances (ie pain cases).

The important thing to remember about both of the above is that if your contracts don't include payment for the rev codes, then there will be no reimbursement.  Because both of the above have payment indicators of N1, they are also not payable by Medicare and like plans.

The AAPC has a study guide available for ASC's.  The guide itself if good, however I was disappointed that there were only 15 test questions.

Hope this helps
Mary, CPC,COSC


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## dmd28 (Jan 19, 2009)

*ASC Question*

Hello, Is there any other training information out there for ASC Facility Billing besides the Medicare Website and the training guide from AAPC?  Perhaps a specialty book or something?   I am also fairly new to ASC facility billing, and while I have learned that there are some supply's and implants, etc... we can separately code for, it would be great to have something at our fingertips we can refer to.  Anybody know of anything like this.   Feel free to email me privately ddavidsonrcc@yahoo.com. 

TIA
Dawn, CPC,RCC


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## missybroussard1017 (Jan 19, 2009)

*Asc Fee Guidelines*

Hello!

My name is Missy I have been doing billing and coding, compliance for 17 years and here are some rules to consider when trying to figure out ASC fees:

What is the reimbursement methodology in the ASC Fee Guideline?
email me at missyb1017@yahoo.com and i will send the step by step for anyone who needs help!


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## codedog (Jan 20, 2009)

*Advice*

I too work at an ASC.  I tried billing mesh codes and porth a cath codes codes for the implants and always get denied. I'M  not the actual biller, just a coder and the billers tell me what they get denied for. I know it comes down to the contracts but it seems like no one is listening. I read these forums and see how everone else is  getting paid but  not where I work at . Like  I said , I'AM coding it. Can anyone give me some advice on how to approach this situation , wHAT i can tell my supervisor, and office manager. ANY advice or links well help. 
                      thank you very much


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## mbort (Jan 20, 2009)

do your contracts allow for payment?


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## codedog (Jan 20, 2009)

NOT SURE M BORT, evertime I asked I get the run around, should I code it ?


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## mbort (Jan 20, 2009)

trent123 said:


> NOT SURE M BORT, evertime I asked I get the run around, should I code it ?



yes I would.  If the contracts allow for it, they should be paid.


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## eguerrero (Aug 25, 2022)

missybroussard1017 said:


> *Asc Fee Guidelines*
> 
> Hello!
> 
> ...


Hi Missy,  I tried to email you but it was kicked back.  Can you send me this information if you still have it?  emily.gue67@gmail.com
thank you!!


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## Ahodge20 (Nov 16, 2022)

eguerrero said:


> Hi Missy,  I tried to email you but it was kicked back.  Can you send me this information if you still have it?  emily.gue67@gmail.com
> thank you!!


Hi Emily, I saw this post is from 2009 - were you able to get ASC information? I am on the managed care plan side and trying to find out how ASC's are being reimbursed, by what fee schedule/rate/program. Any information helps!


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