# Pain management in an ASC



## DLB (Apr 7, 2008)

I was wondering if someone could help me.  I work in an ASC and we are having trouble billing for the fluoroscopic guidance in LESIs, CESIs, TESCIs, stimulators, pumps, etc.  Can anyone please tell me which flouro code you use and the revenue code that you use? Thank you very much.


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## cconroycpch (Apr 9, 2008)

The cpt code would be 77003 - but most insurance companies will not pay you for it.  I believe the rev code is 320, but not 100% sure on that.


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## bporro (Apr 20, 2008)

*Fluoroscopy*

Yes the code is 77003 and 320 revenue code.....Medicare will not pay for it considers it part of the ASC reimbursement, but some private carriers will pay, workman's companies, and liability insurance (auto) companies will pay.  Even the TC modifier will not get it paid by Medicare, but be sure to use it with all these others... you should get some reimbursement.

Barbara Porro RN, CPC


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## elenax (Apr 21, 2008)

I work for an *ASC* and I billed under *revenue code 490* designated for *Ambulatory Surgical Care. *


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## mbort (Apr 21, 2008)

490 is the appropriate rev code for surgical procedures in an ASC but not for Fluoroscopy or x-rays codes.


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## elenax (Apr 22, 2008)

mbort, very interesting...can you direct me to a link to get additional information on the revenue code for fluroscopy, please


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## scgcpc2002 (Apr 22, 2008)

*pain mgmt*

I bill for an ASC also and we do pain managment also.
I use 77003 for the cpt and the revenue code is 320, but these are not paid by many providers.....hope this helps.


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## mbort (Apr 24, 2008)

Here is the link you requested that will show you a few of the revenue codes.

http://www.hcpro.com/content/208881.cfm


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## elenax (Apr 24, 2008)

Thank you, very good information!!....

Correct me if I'm wrong but this is what I understand from the information provided:


"For _*every(*and I believe this will include a *77003 if* performed*)*_ CPT code *listed *on the UB-04 claim form, the CPT code for procedure(s) performed _*should be listed*_ with a *490* revenue code for *ASC surgical procedures". * I think the *320* is used by *radiology* providers. Anyway, we don't get paid  just for auto or work comp.

thanks again!!!


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## mbort (Apr 24, 2008)

no--77003 is a radiology code---therefore the 320 is the appropriate revenue code.  Physicians/radiologists do not use revenue codes.  Revenue codes are for facilities such as ASCs


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## elenax (Apr 25, 2008)

mbort, thank you for clarifying!!


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## pinnaclephyserv (Feb 26, 2009)

Do the facility have to keep the images in the chart?

Thanks,


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## mbort (Feb 26, 2009)

pinnaclephyserv said:


> Do the facility have to keep the images in the chart?
> 
> Thanks,



Its not necessary to keep them in the chart, but yes the ASC should have them on file as it is a part of the medical record.


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## codedog (Feb 26, 2009)

thank you m bort-  you helped me out too. trent


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