Sunday, August 1, 2010

Asc seperate billing services - prosthetic,ambulance ,Leg, Arm, Back and Neck Braces

Prosthetic Devices

Prior to January 1, 2008, an ASC was allowed to bill and receive separate payment for implantable prosthetic devices other than IOLs that were implanted, inserted or otherwise applied by surgical procedures on the ASC list of approved procedures. The ASC billed the local contractor and receives payment according to the Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule. However, an IOL inserted during or subsequent to cataract surgery in an ASC was included in the facility payment rate.

Effective January 1, 2008, payment for implantable prosthetic devices without OPPS pass-through status is included in the ASC payment for the covered surgical procedure. ASCs may not bill separately for implantable devices without OPPS pass-through status.

If the ASC furnishes other non-implantable prosthetic devices to beneficiaries, the ASC is treated as a supplier and all the rules and conditions ordinarily applicable to suppliers are applicable, including obtaining a supplier number and billing as directed by the jurisdiction list.

Ambulance Services
If the ASC furnishes ambulance services, the facility may obtain approval as an ambulance supplier to bill covered ambulance services.

Leg, Arm, Back and Neck Braces

These items of equipment, like non-implantable prosthetic devices, are covered under Part B, but are not included in the ASC facility payment amount for ASC services. If the ASC furnishes these to beneficiaries, it is treated as a supplier and all the rules and conditions ordinarily applicable to suppliers are applicable, including obtaining a supplier number and billing the DMERC or DME MAC where applicable.
Artificial Legs, Arms and Eyes

Like non-implantable prosthetic devices and braces, this equipment is not considered part of an ASC facility service and is not included in the ASC facility payment for ASC services. If the ASC furnishes these items to beneficiaries, it is treated as a supplier and all the rules and conditions ordinarily applicable to suppliers are applicable, including obtaining a supplier number and billing the DMERC or DME MAC where applicable.

3 comments:

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