mgutirob
Contributor
I work for a Pain Management Center and we also have a ASC right next door. My provider performs Kyphoplasty (22514) in the ASC POS (24). He asked if he could bill it out as POS (11) because the rep. from the company told him that we could because the reimbursement rate is higher. The Administrator asked me if that is permitted and I told him that we can't do that because it would be considered Fraudulent Billing. If the service is performed in the ASC, that is how the claim should be processed both ASC and Physician's Component. If there is a seasoned Pain Management Coder with ASC experience, could you please respond so that we may either speak or email. Your assistants with this would be greatly appreciated.