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ASC Coding Essentials: Understanding Facility vs. Physician Coding Differences

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Presenter Bob Lathrop, CPC, CPC-I, CASCC
Broadcast Date 6/3/2026 Add this to your calendar!
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
1 CEU
A
Coding Billing Auditing Compliance Management
ASC Coding Essentials: Understanding Facility vs. Physician Coding Differences Webinar

Learn more about this event

The presentation commences by establishing the foundational definition and regulatory parameters of the Ambulatory Surgery Center (ASC). An ASC is a distinct, independent healthcare entity—or a facility operated under the common ownership and control of a hospital—that operates exclusively for the purpose of providing outpatient surgical services to patients who do not require acute hospitalization. These facilities must maintain a formal agreement with the Centers for Medicare & Medicaid Services (CMS) under 42 CFR 416 Subpart B.

As surgical technologies advance and anesthetic techniques improve, the volume of high-acuity procedures transitioning from the inpatient hospital setting to the ASC environment has grown exponentially. However, this clinical migration has been accompanied by significant financial and compliance risks. According to the 2024 Medicare Fee-for-Service Supplemental Improper Payment Data, the improper payment rate for ASCs stands at a critical 14.7%, representing a projected improper payment amount of $656.3 million. The majority of these financial errors stem from insufficient documentation, totaling 58.8% of the improper payments, alongside incorrect coding applications. Consequently, the mastering of ASC facility coding requires a nuanced understanding of multiple overlapping code sets, stringent regulatory edits, and complex reimbursement methodologies that differ drastically from traditional physician professional billing.

Learning Objectives/Agenda

• Key Structural Differences Between ASC and Professional Coding
• ASC Bundling, Modifiers, and Compliance Considerations
• Surgical Specialties and CPT Knowledge for ASC Coders
• HCPCS Coding for Implants, Supplies, and Drugs
• ICD-10-CM Coding Differences in ASC Claims

Why is this topic important?

As CMS updates their Outpatient Prospective Payment System, more surgeries are moving to an ASC setting. Those in the ASC coding, billing, and compliance world must stay up to date on all surgery specialties that may be performed in a “same day” surgery setting.

Who would benefit from this topic?

• Surgery Coders
• Surgery Auditors
• ASC Billing Staff
• ASC Administrators
• ASC Business Office Managers
• Auditing companies looking to add ASC coding to their fold

Bob Lathrop, CPC, CPC-I, CASCC

About The Author

Bob Lathrop, CPC, CPC-I, CASCC

Coding Director, Surgical Information Systems<br>
Bob Lathrop serves as Coding Director at Surgical Information Systems (SIS), where he empowers ambulatory surgery centers (ASCs) to operate smart through comprehensive coding compliance, education, and audit programs. Leveraging over a decade of ASC-specific coding and reimbursement expertise, Bob partners with ASC administrators, business office leaders, and physician-owners to drive accuracy, ensure regulatory compliance, and optimize financial outcomes.<br>
His leadership includes developing and overseeing coding education initiatives and internal audit processes, supporting ASCs in mitigating audit risk and achieving best-in-class reimbursement. Bob collaborates closely with SIS revenue cycle and product teams to interpret evolving payer requirements and regulatory updates, ensuring partners remain agile amid complex procedural reporting landscapes.<br>
Before joining SIS in 2024, Bob owned and operated a specialized ASC coding and compliance firm for 12 years, delivering consultative solutions to improve compliance and cash flow. He is a Certified Professional Coder (CPC), Certified Professional Coding Instructor (CPC-I), and Certified Ambulatory Surgery Center Coder (CASCC). Bob holds a degree in Business Administration and Management with a focus in business psychology from the University of Kansas.<br>
Recognized for his practical and education-driven approach, Bob offers trusted guidance to ASCs striving for operational efficiency, compliance assurance, and sustainable financial performance in a rapidly evolving industry.

 

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