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Understanding Basics of Ambulatory Coding

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 […]

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Key Opportunities in out-of-network Strategy for ASC

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 […]

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Understanding ASC Billing and Coding

Understanding ASC billing and coding

Starting January 1, 2008, the Centers for Medicare & Medicaid Services (CMS) revised the procedures eligible for ASC payment annually. Furthermore, CMS issued quarterly updates to the lists of covered surgical procedures and ancillary services to set payment indicators and rates for newly introduced Level II HCPCS and Category III CPT Codes pertaining to ASC […]

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ASCs vs HOPDs – Understanding Payment Difference

ASCs vs HOPDs – Understanding Payment Difference

ASCs vs HOPDs: When performing outpatient procedures, many orthopedic surgeons operate in either ASCs or a hospital-based outpatient department (HOPD). Although some of the workflows and services offered may appear similar between the two, the background operations are substantially different from business and regulatory perspectives. An HOPD is owned by and typically attached to a […]

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How to maintain the general surgery billing in ASC facility?

How to maintain the general surgery billing in ASC facility?

Ambulatory surgical centers (ASCs facility) uniquely provide outpatient healthcare to the US population. By providing specialized services outside the hospital setting, ASCs allow patients greater access, a higher level of convenience, and more focused and cost-effective care when undergoing procedures that do not require overnight stays. Billing for services performed in an ASC is similar […]

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