Services included in ASC claim - should not submit different claims

What Ambulatory Surgical Center (ASC) services are included in the ASC payment for a covered surgical procedure under the revised ASC payment system?

ASC services for which payment is included in the ASC payment for a covered surgical procedure include, but are not limited to, the following:

• Nursing, technician, and related services;
• Use of the facility where the surgical procedures are performed;
• Any laboratory testing performed under a Clinical Laboratory Improvement Amendments of 1988 (CLIA) certificate of waiver;
• Drugs and biologicals for which separate payment is not allowed under the outpatient prospective payment system (OPPS);
• Medical and surgical supplies not on pass-through status under the OPPS;
• Equipment;
• Surgical dressings;
• Implanted prosthetic devices, including intraocular lenses, and related accessories and supplies not on pass-through status under the OPPS;
• Implanted durable medical equipment (DME) and related accessories not on pass-through under the OPPS;
• Splints and casts and related devices;
• Radiology services for which separate payment is not allowed under the OPPS, and other diagnostic tests or interpretive services that are integral to a surgical procedure;
• Administrative, recordkeeping, and housekeeping items and services;
• Materials, including supplies and equipment for the administration and monitoring of anesthesia; and
• Supervision of the services of an anesthetist by the operating surgeon.

Under the revised ASC payment system, the above items and services fall within the scope of ASC facility services, and payment for them is packaged into the ASC payment for the covered surgical procedure.