6 Critical Things to Know Ambulatory Surgery Center Billing & Coding Services

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6 Critical Things to Know Ambulatory Surgery
Center Billing Coding Services

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Introduction

• Many Providers and healthcare organizations
  partner with experienced medical billing
  companies in the hopes that they would be offered
  ASC billing services as well.
• However, most US medical billing companies lack
  the skill to process ambulatory surgical center
  billing.
• ASC medical billing and coding are not like
  processing normal physician billing claims. It
  has so many differences and is quite complicated
  in terms of billing and coding.

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• As there is room for huge claim denials, the
  in-house medical billing team cannot tackle both
  normal and ASC billing independently.
• Therefore, partnering with an offshore vendor
  that is skilled in Ambulatory surgical center
  billing would be the best solution.
• In this article, lets learn about the 6 critical
  things about ASC billing and coding services and
  how offshore vendors help in tacking them

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Facts about ASC Billing

• In what way ASC medical billing and coding is
  different from normal physician billing? To know
  the answer, first, we have to understand how
  ambulatory surgical centers work.
• According to Medicare, ASC is an independent
  organization that provides outpatient surgical
  services exclusively to its clients.
• Sometimes, it can be run as a part of a huge
  healthcare facility and called as a
  provider-based department of the hospital. ASC
  do not provide office visits, laboratory services
  or run diagnostic tests

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New Trends

• To be eligible for reimbursements, Medicare
  expects ASCs to sign up a participating-provider
  agreement with CMS.
• To reduce huge patient bills, CMS is planning to
  make ASCs into bed-less hospitals. This way,
  patients can get their surgeries done and
  discharged the same day.
• They can recuperate at the comfort of their own
  homes by getting in touch with their Providers
  via phone.

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How is Ambulatory Surgical Center Billing Done?

• Unlike normal physician billing, ambulatory
  surgical centers use a combination of both
  hospital and physician billing
• Most of the ASC billing services are billed using
  CPT and HCPCS Level II codes. However, some
  insurance companies allow ASC services to be
  billed using ICD-9-CM codes
• ASC claims should be filed using the CMS 1500
  form as per Medicare guidelines
• Medicare also requires the usage of CG modifier
  to distinguish between ASC bill and physician bill

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Approved Surgical Procedures

• According to CMS, only certain approved
  procedures can be done under an ASC setting. The
  list includes,
• Non-emergency and life-threatening procedures
• Procedures that cannot be done in a physicians
  office safely
• Elective procedures
• Urgent procedures

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Best Practices to avoid Critical Errors

• Some of the best practices to avoid critical
  errors in ambulatory surgical center billing are
  as follows,
• It is always advisable to read the complete
  surgical report instead of just considering the
  procedure heading while coding
• Sometimes, a procedure started arthroscopically
  might have been changed to an open procedure due
  to complications. It should be considered as an
  open procedure only during billing. Many coders
  mistakenly bill for both procedures, which is
  wrong

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About e-care India

• For those companies who are on the lookout for an
  experienced ASC billing vendor, e-care India will
  be the prudent choice for medical billing
  services.
• It has expertise in working for over 25 medical
  specialties and with more than 30 billing
  software, which most billing companies in other
  nations lack.
• It has all the necessary security certifications
  including the SSAE 18, which is an added
  advantage.
• To know more about e-care and its services, log
  on to www.ecareindia.com.

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