ambulatory surgical centers Archives

Understanding Basics of Ambulatory Coding

Before we dive into understanding the basics of ambulatory coding, let’s define Ambulatory Surgical Centers (ASC). Defining Ambulatory Surgical Centers (ASC) The Centers for Medicare & Medicaid Services (CMS) defines Ambulatory Surgical Centers (ASCs) as facilities that provide same-day surgical care, including diagnostic and preventive procedures. ASCs are also sometimes referred to as outpatient surgery […]

Billing Guidelines for Bilateral Surgeries

Bilateral Surgeries Billing Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same day. Medicare makes the payment for bilateral procedures based on the lesser of the actual charges or 150 percent of the Medicare Physician Fee Schedule (MPFS) amount when the procedure is authorized […]

Key Opportunities in out-of-network Strategy for ASC

The beginning of the Patient Protection and Affordable Care Act resulted in millions of Americans becoming insured on plans with out-of-network benefits. Also, this act has narrowed insurance networks which left many providers completely out-of-network. Therefore, the out-of-network strategy for ASC is only revenue revenue-enhancing strategy for some ASCs. There are some key opportunities available […]

Basics of Medicare Payment for Ambulatory Surgical Services (ASCs)

Medicare covers surgical procedures provided in freestanding or hospital-operated ambulatory surgical services centers (ASCs). In January 2008, Medicare began paying for facility services provided in ASCs— such as nursing, recovery care, anesthetics, drugs, and other supplies—using a new payment system that is primarily linked to the hospital outpatient prospective payment system (OPPS). (Medicare pays for […]

Ambulatory Surgical Center Terminated Procedures

Ambulatory Surgical Center Terminated Procedures The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient. Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient […]

Understand Payment Rates and Basics of ASC Billing

Basics of ASC Billing The Basics of ASC billing encompass the financial processes associated with Ambulatory Surgical Centers (ASCs). CMS defines an Ambulatory Surgical Center (ASC) as a facility that provides outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures at an ASC are more extensive than […]

ASC Coding And Billing: Knowing What’s Important

The basics of ASC Coding And Billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. ASCs use a combination of hospital and physician billing. Although ASCs use CPT and HCPCS Level II codes to bill most of […]

CMS-Proposed Rule: Changes to the Ambulatory Surgical Center Payment

The Center for Medicare and Medicaid Services (CMS) proposed a new rule that will update the payment policies and rates. The update will specifically cater to Hospital Outpatient and Ambulatory Surgical Centers (ASC). The rules will set forth a motion to promote efficient service and promote higher quality service for all the Medicare beneficiaries. The […]

Maximize the Value for Your Ambulatory Surgical Center in 2018

The ambulatory surgical center was invented about four decades ago. The centers have proven exceptional abilities to improve customer care and quality facility which have been provided along with simultaneously reducing the costs. With the time when the majority of the shift witnessed in the healthcare industry with the technology advancement which is expensive; ASCs […]

Inpatient and Outpatient Services from ASC Centers: Journey From Approved To Covered

Ever since their inception, Ambulatory surgery centers (ASCs), have been providing improved quality and customer service to the healthcare industry. ASCs offer patients the opportunity to have selected surgical and procedural services performed outside the hospital setting. ASC Centers perform more than 7 million procedures for Medicare beneficiaries needing same-day surgical, diagnostic, and preventive procedures. […]

Read our latest medical billing and RCM related blogs