{"id":8172,"date":"2018-09-27T21:00:23","date_gmt":"2018-09-27T15:30:23","guid":{"rendered":"http:\/\/www.medicalbillersandcoders.com\/blog\/?p=8172"},"modified":"2025-07-21T08:36:47","modified_gmt":"2025-07-21T08:36:47","slug":"asc-coding-and-billing-knowing-whats-important","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/asc-coding-and-billing-knowing-whats-important\/","title":{"rendered":"ASC Coding And Billing: Knowing What\u2019s Important"},"content":{"rendered":"

The basics of ASC Coding And Billing\u00a0aren\u2019t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what\u2019s 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 their services (as do physicians), some payers will allow an ASC to bill ICD-10-CM procedure codes (like a hospital). Some payers even base implant reimbursement on revenue code classification.<\/p>\n

One of the most fundamental differences between billing for professional services and billing for ambulatory surgery center services is the concept of the global surgical package. The global package applies to the professional component of a surgical service that is performed when using a surgical CPT code. On the professional side, this typically encompasses a 90-day follow-up. In the ASC billing<\/a> methodology, no such surgical package exists.<\/p>\n

Therefore, each time a patient enters the operating room represents a unique and separate encounter and has no historical economic relationship to previous encounters. This is a very important difference and very often leads to the need for qualifying modifiers. Those modifiers tend to clarify a situation such as returning to the operating room on the same day or returning to the operating room by another doctor on a different date.<\/p>\n

It\u2019s important to use the proper form when submitting claims. Medicare pays for ASC services under Part B and requires the CMS-1500 claim form. Some third-party carriers will accept the CMS-1500 form, while others allow the UB04.<\/p>\n

Approved List of ASC Coding And Billing:<\/h2>\n

For Medicare patients, you cannot perform just any procedure in the ASC setting. Medicare has an \u201capproved\u201d list of procedures for the ASC that CMS has determined not to pose a significant safety risk, and that is not expected to require an overnight stay following the surgical procedure.<\/p>\n

The list of approved procedures is based on the criteria:<\/h3>\n
    \n
  • They are NOT emergent or life-threatening (for example, a heart transplant or reattachment of a severed limb).<\/li>\n
  • They CANNOT be performed safely in a physician\u2019s office.<\/li>\n
  • They can be electives.<\/li>\n
  • They can be urgent.<\/li>\n<\/ul>\n

    Procedures also do not involve major blood vessels or result in major blood loss, and cannot involve prolonged invasion of a body cavity.<\/p>\n

    Medicare publishes this list of covered procedures annually. Updates are published quarterly, or as necessary. The file consists of two addenda listing approved surgical procedures and covered ancillary services.<\/p>\n

    Medicare Claims Submissions of ASC Coding And Billing:<\/h2>\n

    There is a separate set of billing rules for ASCs. While some issues may be addressed by CMS, most billing guidelines are best obtained from your local carrier or intermediary. Some carriers\/intermediaries issue very detailed guides (e.g., Trailblazer), while others may simply provide a list of links to the CMS website (e.g., Empire).<\/p>\n

    To reiterate, an ASC must not report separate line items, HCPCS Level II codes, or any other charges for procedures, services, drugs, devices, or supplies that are packaged into the payment allowance for covered surgical procedures. The allowance for the surgical procedure itself includes these other services or items.<\/p>\n

    References:<\/h3>\n
      \n
    • Medicare Claim Processing Manual.<\/li>\n<\/ul>\n

      FAQs:<\/h2>\n\n\n
      1. What is the global surgical package in ASC billing?<\/strong>

      The global surgical package does not exist in ASC billing; each surgery is treated as a separate encounter without historical ties to previous visits.<\/p> <\/div>

      2. What claim form is used for ASC billing to Medicare?<\/strong>

      Medicare requires the CMS-1500 claim form for ASC services, although some third-party payers may also accept the UB04 form.<\/p> <\/div>

      3. What procedures are approved for ASCs by Medicare?<\/strong>

      Medicare has an approved list of procedures that are elective, urgent, non-emergent, and safe to perform in an ASC without an overnight stay.<\/p> <\/div>

      4. How often does Medicare update the list of approved procedures for ASCs?<\/strong>

      Medicare publishes updates to the list of approved procedures annually and may also provide quarterly updates as needed.<\/p> <\/div>

      5. Can ASCs bill separately for packaged services?<\/strong>

      No, ASCs must not report separate charges for services or items packaged into the payment allowance for covered surgical procedures.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"

      The basics of ASC Coding And Billing\u00a0aren\u2019t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what\u2019s 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 […]<\/p>\n","protected":false},"author":2,"featured_media":8175,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[662],"tags":[3731,914,743,1086,3732,3729,3730,82,84,15,20,11,1128,1136,163,86,27],"class_list":["post-8172","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ambulatory-surgical-centers","tag-ambulatory-surgery-center-services","tag-ambulatory-surgical-centers-2","tag-ambulatory-surgical-centers-billing","tag-american-healthcare-billing-services","tag-asc-billing-methodology","tag-asc-coding-and-billing","tag-cpt-and-hcpcs-level-ii-codes","tag-icd-10-codes","tag-icd-10-implementation","tag-medical-billing","tag-medical-billing-and-coding","tag-medical-billing-outsourcing","tag-medical-billing-services-in-florida","tag-medical-billing-services-in-usa","tag-outsourced-medical-billing","tag-physician-billing","tag-revenue-cycle-management-2"],"yoast_head":"\r\nASC 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