Tuesday, June 29, 2010

ASC bilateral procedure payment

Bilateral procedures under the revised ASC payment system

How should Ambulatory Surgical Centers (ASCs) report bilateral procedures under the revised ASC payment system?

Bilateral procedures should be reported as a single unit on two separate lines or with “2” in the units field on one line, in order for both procedures to be paid. While use of the -50 modifier is not specifically prohibited according to CMS billing instructions, the modifier will not be recognized for payment purposes and may result in incorrect payment to ASCs. The multiple procedure reduction of 50 percent will apply to all bilateral procedures subject to multiple procedure discounting.

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