ASC Coding Services

The demand for ASC coding services is on the rise as more and more services have started relying on it because of the intricate nature of the job.  As you may already know, Ambulatory Surgical Centers (ASCs) perform a wide range of outpatient surgical procedures. Unlike hospitals and other in-patient facilities, an ASC performs procedures that do not require an overnight stay. Here are some common surgeries that are typically performed in ASCs:

  • Cataract surgeries
  • Arthroscopy
  • Colonoscopy
  • Endoscopy
  • Hernia repair
  • Pain management procedures
  • Podiatric surgeries
  • Dental and oral surgeries
  • Dermatological procedures
  • GI procedures
  • Gynecological procedures
  • Orthopedic surgeries
  • Urological procedures

ASCs take care of a lot of patient-care-related activities but one thing they cannot ignore are the coding and billing responsibilities as their cash flow and overall revenue structure depend on this area.

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Unfortunately, understanding the guidelines for ASC documentation and coding is not an easy job as it requires sound knowledge and deep expertise to do full justice to the demands of such tasks. 

Medicare has already set up a well-defined payment classification system for all services provided on an outpatient structure in ASCs. Every Medicare-covered service in ASC is assigned a specific CPT code. However, there are multiple things to keep in mind. For example, in case multiple procedures have been billed under a single claim, payment doesn’t need to be made at the same rate for each procedure. The first procedure is paid at 100% of the allowed rate whereas additional procedures are paid at 50% of the allowed rate.

In ASC, Healthcare Common Procedure Coding System (HCPCS) II is used for covering drugs and devices. In an ASC setting, HSPCS coding can be a little tricky. CMS has a specific list of HCPCS II Devices and Drug Codes that can be assigned in all settings including ASC. But, when the same devices are used in ASC in an outpatient environment, they must be billed jointly with Device C codes.

Currently, Ambulatory Surgical Centers (ASCs) utilize codes from the Current Procedural Terminology (CPT) and the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM) for the classification of diagnoses, procedures, drugs, and devices. However, ASCs are expected to adopt the latest updates from the International Classification of Diseases, 11th Edition (ICD-11) for diagnosis coding once these updates come into effect.

In the context of Medicare billing for ASCs, the utilization of C-codes is not required, unlike in outpatient settings. Nevertheless, it is important to note that Medicare has distinct rules and regulations governing reimbursements for drugs and devices in ASCs, necessitating adherence to specific guidelines in these cases.

Using modifiers is also not so simple in ASC. Some modifiers are the same as those used by physicians, while others are used in ASC only, ASCs have their unique modifier for discontinued procedures. For example, modifier 73 discontinued the ASC procedure before the administration of anesthesia is used. Modifier 74 discontinued ASC procedure after anesthesia is used when the procedure is terminated after anesthesia is administered.

Some of the common ASC codes are:

  • CPT Code 23472 – Arthroscopic rotator cuff repair
  • HCPCS Code G0260 – Removal of cataract with insertion of lens
  • CPT Code 43249 – Esophagogastroduodenoscopy with ablation of tumor(s)
  • HCPCS Code J7321 – Hyaluronic acid for injection into knee joint

Key Challenges with Coding Support for Ambulatory Surgical Centers

  • Patient health coverage
  • Insufficient documentation of medical necessity
  • Inaccurate coding and inability to adhere to compliance requirements

Furthermore, amateur coders often forget to mention the Place of Service (POS) codes, leading to denials, audits, and penalties from payers.

Are you also feeling overwhelmed to manage both the patient care and medical billing and administrative responsibilities? If yes, it’s high time to focus on your skill which is patient care, while outsourcing your billing responsibilities to one of the best Ambulatory Surgery Centers coding companies in the market.

Outsource ASC Coding Services to Sunknowledge

As one of the nation’s leading Coding Services for ASC Practices with almost two decades of experience, we know what it takes to streamline your end-to-end medical billing infrastructure. We have in-depth knowledge and expertise in handling different CPT, ICD-10 and HCPCS codes related to ASC and all the latest modifiers. Our certified coders always keep themselves updated with the latest guidelines and changes in the coding domain.

We provide a wide range of support with excellent references from leading clients from the ASC domain.

Our market-leading coding support for Ambulatory Surgical Centers offers:

  • Diligent and accurate charge sheet delivery within the TAT given by clients
  • We always monitor, analyze and assign accurate codes to avoid any potential denials and receive optimal reimbursements
  • Each of our certified coders is upgraded with the latest ASC coding advancement knowledge so that we can stay in sync with current practices
  • We always focus on a prompt report-back mechanism
  • All our coders are ICD-10 certified
  • We always maintain 99.9% coding accuracy
  • We are 100% HIPAA-compliant

Very nice and looks like things are off to a GREAT start with Sunknowledge Team’s abilities! I wouldn’t expect anything less from Sun

Practice Administrator,
Leading Heart & Vascular Center in Virginia

Choosing Sunknowledge as your ASC coding services partner could be your perfect strategic decision.

As a company based and managed in the United States, with our headquarters situated in New York City, we offer you the opportunity to decrease operational costs by as much as 80%. Whether your objective is to surpass your competitors or streamline expenses, we are ready to support you in accomplishing your goals.

If you want to know more about our comprehensive RCM services, feel free to set up a no-obligation call today.

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