Hello,
What tips or suggestions can be provided for billing implants in a consistent manner? I am looking to understand what the rules/requirements are related to billing implants performed as part of a surgery in an ASC setting. My primary focus is on out-of-network.
What implant documents are required for billing purposes?
Are there limitations or usual and customary charges associated with billing implants?
I understand that much of implant billing is dictated by predefined contracts; however, how does it work with out-of-network billing of implants?
If an invoice is provided, but no price is listed on the invoice, can the ASC bill any amount for the implant (out of network)? Implants are generally reported under revenue code 278 (itemized) or captured as C/L HCPC codes- can a predefined price be established to cover all implants that can fall under these codes, or is the price to bill largely dependant on the actual price of the implant?
Any other general guidelines or best practices related to implant billing is appreciated! Thank you.