Situation - ASC is attached to physician office, patient is having postop sutures removed in office but does not feel comfortable. Physician takes patient to the ASC to remove sutures under local. Physician cannot bill but can the ASC bill for the service?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Can I bill this?
- Thread starter kparkhurst
- Start date
mitchellde
True Blue
yes , but did the patient know that they would be charged a co-ins amount for this? does the provider have any vested interest in the ASC? In otherwords did the provider knowing that he could not charge for this purposefully have it performed at the ASC in order to generate a charge as he has the ability to profit from this.
Yes, the physician has vested interest in the ASC. The way the report reads, the patient made the request. It's a tough call because after querying one of the nurses, it seems that it was a retained suture that they had trouble removing in the office - which is not how the report reads.
mitchellde
True Blue
That is a tough one then, You would need I think, for the provider to revise his report to state that there was a retain suture and with the patient consent the procedure was moved to the ASC where better equipment could be used to assist in the removal. If the patient fights the co-ins amount you may have a tough one on your hands.
Kevinph84
Guest
For suture removal - you may get paid very little or not paid at all. Pending on the report, the code selected may be considered an office procedure. This is all pending on individual contracts. Your patients also need to be made aware of the fact your physician has some stake into the facility.