Wiki New ASC

[aprilroc]

I work in Orthopaedics and I do all the coding and billing from the office standpoint. We are opening our own ASC in July of this year. I need to start at the bottom of learning facility coding and billing, any suggestions? Thanks.

 

[mbort]

First and foremost...make sure that whomever is handling your contracts...DO THEM RIGHT!! make sure they capture implants, carveouts, radiology, high cost drugs, etc.

 

[aprilroc]

We have hired a company to do all the negotiations of our contracts. I just now am stressing about coding and billing since our opening date is nearing.

 

[mbort]

good. ASC coding is very similar to physician coding, you will have different forms, except for MCR and Medicaid, for the most part you will be using UB94's, some workers comp carriers still want HCFA's though, that will be trial and error.

What specific questions do you have?
Are you familiar with the TC modifier?
Are you familiar with ASC approved modifiers?
Are you familiar with revenue codes?

 

[aprilroc]

I am not familiar with the Revenue codes. The TC modifier from the xray standpoint in the physician office. I am gonna have to start at the bottom. I am just looking at the Outpatient Surgery Maximun Allowable Reimbursement in the Georgia Workers Compensation Fee Schedule and am very confused by the codes.

Specifically I would like to know. What you have to have listed on your claim to bill for the facility. Also is there anything specific that I need watch for to make sure I do not loose revunue.

 

[jayne]

Cpc-h

I haven't seen the CPC-H study guide, but I have seen the CPC study guide and thought it was excellent and fairly inexpensive. I would also try to go to some seminars. Coding Compliance Management at ccmpro.net are really good, I think. You may also be able to find an AAPC seminar.

 

[martnel]

Make sure you know who is paying for Implants and who not, before you schedule surgeries w/implants. Those can run up to thousands! We mostly use code L8699.