Author Topic: Pain Management and ASC questions  (Read 1154 times)

Kristen Bridges

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Pain Management and ASC questions
« on: January 20, 2014, 08:41:47 PM »
HELP! I work for a pain management group and have recently started their billing. My coworkers and I are very familiar with CMS-1500 but do not have much UB-04 knowledge. Our physicians have a clinic and also perform procedures in their ASC. With the exception of Medicare, most of our payers here on TX require ASC billing on the UB-04. I am having trouble finding the answers I need and need them ASAP! Most resources are very specific about CMS 1500 billing but trying to find accurate ASC billing guidelines for pain management is like trying to find a needle in a haystack. Medicaid and Tricare require NDC #s and I am unclear if these are required whether we are billing for the injection drug (clinic) or not (ASC- lidocaine etc). I know how to input them just not their requirements. I have billing experience in ophthalmology and E/M visits but this is a whole new world to me. I've scoured the Internet and feel like I can't get a straight answer. Does anyone know where I can get information? We have tried calling the payers and will continue in that route but seem to be getting transferred to the wrong person and no one knows a straight answer. Thanks in advance! My brain is so fried.


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Re: Pain Management and ASC questions
« Reply #1 on: January 26, 2014, 08:08:07 PM »
If your billing for the physician, you will use a 1500, ASC needs to be on the UB-04, you can actually go on line and type in how to fill out a UB-04 and it should tell what specifics you need on each line. You could also maybe get help from your clearinghouse ? I hope this helps, you have to make sure your referring doctor is there and the billing address of the facility, I think in box 32a. Not sure what your questions are ?