mwagone1
Contributor
I work for a payor and have come across the following scenario:
ASC is billing for the surgery codes (usually spinal injections)
Anesthesiologist is billing for the anesthesia code
Surgeon/Pain Management physician is billing for the meds injected for both the spinal injections (Kenalog, depo-medrol, etc) AND the anesthesia (Versed, Propofol, etc.) along with various other things (nasal cannula, A4670, etc.)
Anesthesiologist and PMGT provider have same TIN
ASC has different TIN
Would everything being billed by the PMGT physician be inclusive to either the ASC or Anesthesia reimbursement? If so, which one?
(Of note is the fact that I do NOT have billing for the spinal injections from the actual treating physician-they just bill for the J/A codes)
Any help would be appreciated!
PS. We follow ALL MEDICARE guidelines, so any quotes/guidelines/info from MC would be awesome!
ASC is billing for the surgery codes (usually spinal injections)
Anesthesiologist is billing for the anesthesia code
Surgeon/Pain Management physician is billing for the meds injected for both the spinal injections (Kenalog, depo-medrol, etc) AND the anesthesia (Versed, Propofol, etc.) along with various other things (nasal cannula, A4670, etc.)
Anesthesiologist and PMGT provider have same TIN
ASC has different TIN
Would everything being billed by the PMGT physician be inclusive to either the ASC or Anesthesia reimbursement? If so, which one?
(Of note is the fact that I do NOT have billing for the spinal injections from the actual treating physician-they just bill for the J/A codes)
Any help would be appreciated!
PS. We follow ALL MEDICARE guidelines, so any quotes/guidelines/info from MC would be awesome!