On Demand: ASC Coding, Documentation, and Reimbursement-Q&A

Q&A

Pdf Summary

In a Q&A session on ASC coding, documentation, and reimbursement, the following questions were addressed:<br /><br />1. Should a modifier be added to anything marked with an N1 status? The answer is no, as N1 status items are bundled into the payment for the primary service performed.<br /><br />2. Is it necessary to use C codes for devices done in an ASC? This depends on the carrier. From a Medicare perspective, reporting both CPT codes and HCPCs codes for device services is recommended.<br /><br />3. Can the Angioseal device be reported by facilities? Yes, the Angioseal closure can be reported using HCPC code C1760. Although it is marked as an N1 status on the ASC Fee Schedule, payment will still be bundled into the primary service performed.<br /><br />4. Is the C7532 (a combination of codes 37246 and 37252) reported to all insurance or just Medicare? This will vary based on the carrier, so it is advisable to check with major payers for any specific policies.<br /><br />5. Can Modifier 50 be used on the ASC Facility side? No, Modifier 50 is not listed as an approved ASC modifier. It is recommended to use the appropriate RT/LT modifiers or consult major payers for policies regarding bilateral procedures.<br /><br />6. When would you use an XE modifier in an ASC setting? Modifier XE, which denotes a separate encounter, is rarely reported in an ASC setting.<br /><br />These questions and answers provide clarification on coding, documentation, and reimbursement practices in an ASC environment.

Keywords

ASC coding

reimbursement

modifier

N1 status

bundled payment

C codes

HCPCs codes

Angioseal device

Medicare

bilateral procedures