Saturday, March 5, 2011

Leg, Arm, Back and Neck Braces,Artificial Legs, Arms and Eyes 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.

Ancillary Services
Medicare pays separate for certain covered ancillary services that are provided integral to covered surgical procedures in ASCs. The ancillary services must be provided immediately before, during, or after a covered surgical procedure to be considered integral and thereby, eligible for separate payment. Medicare also will provide separate payment to the ASC for drugs, devices that are eligible for pass-through payment under OPPS. Payment can also be made for covered ancillary radiology services made to ASCs. ASCs will only receive payment for the technical component of the covered ancillary radiology procedure.

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