Wiki Appropriate ASC Billing Practices

[ckkohler]

Hi!
I'm new to the ASC billing environment. Actually, I don't do the billing as it is outsourced .. but, I would like to increase my understanding as to what is appropriate billing practice and what is not. For example, the billing company will bill two separate facility charges for different injections on the same day. I guess in my mind, I'm thinking they are already in the facility - why would you bill a 100% of the fees for another procedure?

I'm trying to get some education on ASC billing - but, have had some problems. Any thoughts would be appreciated.

Thanks!

 

[kdornes]

Hi, We bill for seperate procedures if the patient is moved from one room to another like when sterotactics are done for breast surgeries. Then we bill 2 different charges. Hope that helped.

 

[mbort]

The only way that your scenario woul dbe ethical is if they leave one room and go to another OR they leave the OR, go to postop and must return to the OR, otherwise they are improperly billing your cases, getting paid for it and potentially increase the risk for refunds and audit.

Hope this helps
Mary