Billing > Billing
ASC Billing- How to?
lindsayk:
I am new to UBO4 billing and am billing for an ambulatory surgical center. Just wondering if we are only allowed to bill 490 for the actual procedures rendered or if we can also be billing seperately for items like implant, plates & screws, or items such as prophylactic medications administered, recovery room time, or surgical supplies used. I guess an example would be...a fracture which was fixed, but the patient was given IBUProfen and prophylactic antibiotics before surgery. The surgery was performed using plates and screws, and then the pt was taken to recovery and discharged from there. Can you give me any insite as to what items can all be billed and what types of rev codes would be used other then the 490? Any info is helpful.
Michele:
You should look thru the list of rev codes to see what ones apply to the services being provided. Also, how does the ambulatory surgical center charge? By procedure? A Global Fee? Or for each thing provided? Does the surgery center provide the plates and screws or is that the surgeon? Do the surgeons work for the ambulatory surgery center or are they separate? Lots of questions, but there are rev codes for the things you've described. For example, 710 or 719 is the rev code for recovery room.
lindsayk:
The facility currently bills for each procedure, but hasn't been billing for items like recovery or plates & screws, or pharmacy items. I guess that is part of my question too, is what is allowed to be billed and what is the best way. The surgeons do work for the facility and so the facility is supplying these extra items. Does that answer your questions to help you help me answer mine? :)
Michele:
The facility can bill for everything that is supplied/provided. Not all insurance carriers will reimburse all items. Some may consider them inclusive. But all should be billed. For example, many in office surgeries will bill separately for the surgical tray but most insurance carriers consider that part of the surgery and don't reimburse separately. Now the facility has to determine if their fee for the facility includes items like screws etc, or if they are going to break it out and bill separately.
lindsayk:
As far as splitting up the items and billing seperately, is there one way or another that you would recommend that insurance carriers typically process better?
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