ASC billing refers to the specialized process of submitting claims for surgical and medical services performed at an Ambulatory Surgical Center (ASC). An ASC is a healthcare facility where patients receive same-day surgical care without an overnight hospital stay. ASC billing involves unique coding, modifier usage, and compliance with payer-specific rules that are distinct from those used in hospital billing, ensuring proper reimbursement for outpatient procedures provided in these settings. In medical billing, ASC stands for Ambulatory Surgical Center. This term defines a healthcare facility where patients receive same-day surgical care without requiring an overnight stay. The ambulatory surgical center in medical billing has its own set of reimbursement guidelines.

ASC coding is the practice of assigning specific CPT, ICD-10, and HCPCS codes for procedures performed in an Ambulatory Surgical Center. Accurate asc coding is critical for ensuring proper reimbursement and avoiding compliance issues.

ASC facility billing covers the costs associated with the center itself—such as supplies, equipment use, and nursing staff. This is separate from the professional fee billed by the surgeon for their services. The two claims are submitted independently.

ASC billing modifiers are two-character codes appended to CPT codes to provide additional information to payers. Common modifiers include SG (for ASC facility services), 73 (discontinued procedure prior to anesthesia), and 74 (discontinued procedure after anesthesia).

Revenue codes are four-digit codes used on UB-04 claim forms to categorize services for payers. Using the correct revenue codes is essential for proper claim processing and payment, as they tell the payer what type of service or supply was provided.

Pain management ASC billing is complex due to the variety of procedures, specific rules for injectables, and strict documentation required to prove medical necessity. Correctly coding for nerve blocks, epidurals, and other interventions is critical for reimbursement.

Yes, ASC RCM outsourcing is a common strategy for centers looking to reduce operational costs, improve efficiency, and gain access to specialized expertise. Companies like Info Hub Consultancy Services provide comprehensive ASC RCM services to manage the entire revenue cycle.