HCPro.com: Ambulatory Surgery Coding & Reimbursement Insider

Each month in Ambulatory Surgery and Compliance Reimbursement Insider you get more of our exclusive working tools: model guidelines, policies, forms, etc., that you can use to comply with OIG and HCFA, reduce claim denials, and get paid in full and on time.

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July 2008 (Volume 5, Issue 7)	view entire issue

CMS adds four separately payable drugs, deletes two other drug codes from list
In April, CMS issued the first quarterly update to the ASC payment system. The changes and billing instructions relate primarily to payment rates for selected separately payable drugs and biologicals, as well as rates and descriptors for newly created Level II Healthcare Common Procedure Coding System (HCPCS) codes for drugs and biologicals.

Stay current on the most recent AMA coding guidelines
For ASCs that offer pain management services, it is important to review past and present AMA guidelines. Doing so ensures that you are accurately coding procedures and not leaving any reimbursement on the table, nor counting on reimbursement that ASCs are no longer eligible to receive. The following are some critical coding and billing updates for ASC managers to share with staff members.

ICD-9-CM diagnosis coding: The key to coverage, payment
Diagnosis codes are important to getting your claims paid. They are the mechanism for providing payers with the what and why of procedures physicians perform. These codes describe diagnoses, signs, symptoms, chronic and acute problems, and conditions. They provide the tools to report the medical necessity of the procedure. When you look up diagnoses in the Alphabetic Index of Diseases in the ICD-9-CM Manual, select a provisional code from the index only; but do not code from the alphabetic index. After you look up the code in the index, turn to the Volume 1 Tabular List and verify the accuracy of the selected code.

Other recently-published articles from Ambulatory Surgery Coding & Reimbursement Insider:

Choose the correct code when reporting SI joint injections

Implement a payment policy and stick to it

Don’t shoot your finances in the foot

ASC 2009 proposed rule holds few surprises

Tackle 12 important medical record documentation issues

Take caution with out-of-network billing strategies

Review troublesome urology codes, coding practices

ICD-9-CM diagnosis coding: The key to coverage, payment

Stay current on the most recent AMA coding guidelines

CMS adds four separately payable drugs, deletes two other drug codes from list

Understand the new cholecystectomy procedures

Offset lower phase-in payments with enhanced service mix

Educate and reeducate physicians on documentation

Take a closer look at new orthopedic procedures

Understand gynecology procedures to ensure correct coding

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