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Does anyone know if a CPC coder is 'covered' to code for an ASC facilty. If so, what are the differences between ASC coding and Physican coding? Besides the TC modifier.
A CPC may code for an ASC but ASC's encompass every specialty. The CASCC exam covered every specialty in the coding book, even though your ASC may only provide services to one or two specialties. There are many differences between ASC and physician-based coding, including use of modifiers and procedure groups. And hospital-based coding is also completely different. In my opinion, it is difficult to go from physician to ASC coding without some instruction.
I agree that a CPC is able to code for an ASC facility. I do think aside from modifiers, understanding the ASC revenue cycle is crucial for ASC Coding and Billing. The Medicare Claims Processing Manual Chapter 14 is a great way to begin knowledge of the ASC system. I feel ASC coding is caught in the middle between Hospital Outpatient and Physician coding. For example, many of the modifiers we use are also used in the Hospital Outpatient setting. Our payment systems are also a bit similar to that of the Hospital OPPS. However, we are reimbursed by Medicare Part B and follow physician NCCI edits. Personally, having both hospital outpatient and physician coding experience prior to working in an ASC, had helped me transition to this setting.