Wiki Posting all procedures

[dericher655]

 I need some information regarding the following. I work in a Penna. ASC that performs only oral rehab. Since the major portion of our patients are PA Medicaid patients I am being told since our contracts with the Medicaid payers are only for one line of service that I only need to post the charges for that one line of service. If any one can point me in the right direction for documentation showing that I woud appreciate it. I have always no matter where I worked, physician office, multispecialty ASC that unless the procedure is a bundled procedure that all procedures performed are to be posted in case of an audit or chart review. Thank you in advance Diane

 

[Kristen Bensel]

I am not sure if you have had any answers from anyone else on this question, but this is my experience with this.

I work for a clinic that has an encounter rate from our state Medicaid. So when the visit is billed to Medicaid, the Primary CPT has the money allocated to it, and all others are billed with a $0.00 so they can see all that we did for the patient and the system reflects all of the services rendered.

However in your situation, I don't know if your facility has an agreement with the payer like we do or not, but would make more sense to bill it like we do with the $0.00?

-Kristen