Author Topic: 99070  (Read 3157 times)

ellie

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99070
« on: January 20, 2011, 07:27:17 PM »
does anyone know if in a ASC for supplies you can use the 99070 ? I used to use it in an office setting but ASC not sure ?

Michele

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Re: 99070
« Reply #1 on: January 22, 2011, 07:34:01 PM »
Usually ASC's charges are billed on a UB04 and you would use a rev code instead of a cpt code.  But in answer to your question, if there is no appropriate HCPCS code, then you can use the 99070, but expect it to be denied requesting specific information on what supplies were provided.

Michele
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tlewis

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Re: 99070
« Reply #2 on: January 24, 2011, 04:17:55 PM »
I live in oregon and do all my ASC billing on a CMS-1500 and no you cannot use 99070. Supplies are usually considered part of the payment. Implants are not covered by medicare but can be covered by insurance companies depending on your contract. the most common code that I use is L8699. it needs to sent in with the invoice to get paid.I usually bill out with cost plus 10%.  here is a link to the oregon alaska and washington fee schedule. https://www.noridianmedicare.com/p-medb/fees/
You will have to look it up for your state but this will give u a guideline. It lists all the CPT HCPC codes and whether they are ASC approved procedures. ASC billing is a whole different ball game then office or hospital billing the rules and regulations are far different. You should be able too look up the ASC rules for your state. and here is a link for the cms manual of ASC's. http://www.cms.gov/manuals/downloads/clm104c14.pdf
Just because other places can bill for procedures does not mean that you can bill it at an ASC. You want to becareful that you aren't unbundling procedures or billing for things that will flag an audit. If you have any questions you can email me. I don't know all but I have been billing for an ASC for 3 years and while every day is a learning experience I would be more than happy to show you some websites that have information for you and help you with anything I can.
http://www.cms.gov/manuals/downloads/clm104c14.pdf

Mecicare lclaim processing manual chapter 14 10.2


ASC services for which payment is included in the ASC payment for a covered surgical procedure under 42CFR416.65 include, but are not limited to-
(a) Included facility services:
(1) Nursing, technician, and related services;
(2) Use of the facility where the surgical procedures are performed;
(3) Any laboratory testing performed under a Clinical Laboratory Improvement Amendments of 1988 (CLIA) certificate of waiver;
(4) Drugs and biologicals for which separate payment is not allowed under the hospital outpatient prospective payment system (OPPS);
(5) Medical and surgical supplies not on pass-through status under Subpart G of Part 419 of 42 CFR;
(6) Equipment;
(7) Surgical dressings;
(8) Implanted prosthetic devices, including intraocular lenses (IOLs), and related accessories and supplies not on pass-through status under Subpart G of Part 419 of 42 CFR;
(9) Implanted DME and related accessories and supplies not on pass-through status under Subpart G of Part 419of 42 CFR;
(10) Splints and casts and related devices;
(11) Radiology services for which separate payment is not allowed under the OPPS, and other diagnostic tests or interpretive services that are integral to a surgical procedure;
(12) Administrative, recordkeeping and housekeeping items and services;
(13) Materials, including supplies and equipment for the administration and monitoring of anesthesia; and
(14) Supervision of the services of an anesthetist by the operating surgeon.


Medicare manual