ASC Billing Basics

Mabhizimisi ekubhadhara mabhizinesi ekuvhiya mabhuku

Chirwere chekuvhiringidza (ASC) chinorondedzerwa neCMS sechinhu chinongoronga chinangwa chekupa rubatsiro rwekurapwa kwenguva refu kune varwere. Ambulatory chirurgical centers inogona kuonekwa neine chipatara-based entity kana kuti inogona kunge iri nzvimbo inoshandiswa kunze kwekuvhiya.

Kunyange zvazvo ASC ichitaura ine zvimwe zvakafanana nezvirevo zvechipatara kana zvasvika pakubhadhara, pane zvimwe zvakasiyana zvakasiyana.

ASC Kubhadhara Mafomu Maitiro - Ndeapi Aungashandisa

Ambulatory chirurgical centre dzinonzi dzinoshandiswa kuMedare, Medicare Advantage Plans, uye Medicaid pane HCFA 1500 kana 837P. Izvi zvakasiyana nechipatara chekuvhiya kunze kwechipatara chinopihwa kune vanobhadhara, izvo zvinoiswa kuB-04 kana 837I.

I-CMS-1500 ndiyo ye-red-ink pamutemo wepepuru wechipatimho chekutsvaga inoshandiswa nevechiremba uye vatengesi nokuda kwekubhadhara mari. Chero ani zvake asiri musangano uye mutengesi anogona kushandisa CMS-1500 pamhosva dzekubhadhara zvekurapa. Iko shanduro yemagetsi yeCMS-1500 inonzi 837-P, iyo P ichimiririra maitiro ekugadzira.

IU-UB-04 kana 837-ini inoshandiswa neAASs kuti ipe zvikwereti zvezvokurapa kune vamwe vose vanobhadhara.

Zvimwe

Bill Type for ASC

Paunenge uchitaura zvitsva paB-04, mutero wekubhadhara weAIDS unofanirwa ndeye 83X.Injiti yekutanga inoreva rudzi rwechirongwa: 8 - Specialty Facility, Chipatara ASC Chirwere Chipiri chechipiri chinoreva kusarudzwa kwematareji: 3 - Muchipatara

Iyo nhamba yechitatu inoreva kuwanda kunomiririra pamusoro nechinotenderera X.

1 - Bvuma kuburikidza neDownload Reve

7 - Kudzorerwa kwePamberi Kutaura kana Kurairirwa Kwemhosva

8 - Chero kana Kuraira kwePamberi Kutora

Revenue Code

Pakuisa zvirevo paB-04, purogiramu yemari inoshandiswa kurondedzera kubhadhara chirwere chepamusoro chirongwa ndeche 490.

Kushandiswa Kwechigadziridzo

ASC zvinodaro zvinogona kunge zvichinyadzisa nokuti vatengi vakasiyana havasi kungodikanwa chete nemhando dzakasiyana dzemafomu ekutsvaga, dzinodawo kushandiswa kwemashanduko akasiyana.

Medicare Modioders

Medicare inoda zvinotevera zvinoshandiswa pakuisa mamwe maitiro emitemo ye ASC inoti:

Shanduko RT - Rutivi rworudyi (rinoshandiswa kuzivisa nzira dzakagadzirwa kurudyi rwemuviri)

Modifier LT - Kurutivi rworuboshwe (anoshandiswa kuzivisa nzira dzakagadzirwa kuruboshwe rwomuviri)

Shanduko TC- Technical component

Modifier 52 - Yakaderedzwa mazano

Shanduko 59 - Kusiyana kwakasiyana-siyana

Modifier 73 - Nzira inopera mushure mekugadzirira kurapwa

Shanduko 74 - Nzira inopera mushure mokunge anesthesia inoshandiswa

Modifier FB - Chirongwa chakagoverwa pasina mari / chikwereti chakazara

Modifier FC - Chirongwa chakagoverwa pachikwereti chisina kukodzera

Modifier PA - Zvakaipa mumuviri

Modifier PB - Kuvhiya kusakanganiswa murwere

Modifier PC - Kuvhiyiwa kusina kunaka kune murwere

Modifier PT - Colorectal kuongorora kuchinjwa kuongororwa kana chirongwa chekurapa / chirwere

Modifier GW - Kuvhiya hakukwanisi ku hospice varwere vechipatara chirwere

Medicaid Modifier

Kunyange zvazvo Medicare inoshandisa izvi zvinoshandiswa, Medicaid hairevi kushandiswa kweimwe yeiyi. Iyo chete inoshandiswa kugadzirisa yeMedicaid is modifier SG iyo inofanidza kudai sechikwata chekuvhiya chirwere chinonzi claim.

Zvakakosha kuwedzera gadziri SG kune imwe yenhamba yeCPT pasinei nomubhadhara kuitira kuti aone kusiyana kwebhadharo kubva kubhizimisi rebasa rebasa rimwechete.

Other Insurer Modifier

Chimwe chiitiko chekusiyana mune kushandiswa kwe modifers ndechokuti Blue Cross Blue Shield ** inoda kushandiswa kwechirongwa chechigadziro 50, chinoparadzanisa nzira yacho seyese nzira, pamwe nezvikamu zviviri zvebasa. Medicare, kune rumwe rutivi, inoda kuti achinje 50 kana kuti achinje RT uye LT pamiganhu yakasiyana ne 1 unit of service.

** Mirayiridzo yekubhadhara inogona kusiyana nehurumende. Tarisa neBBBS yehurumende bhuku kuti uwane.