decisionhealth Newsletters, Answer Books - 2010 Issue 11 (November)
Ambulatory Surgery Centers / Get ready to appeal more ASC denials
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Article Overview
This article is for coders, billers, and physician practices that submit claims tied to ambulatory surgery center services. It reviews CMS clarification affecting ASC-related denials, the general treatment of global service claims in this setting, and the denial messaging that may appear on remittance advice and beneficiary notices.
Why This Topic Matters
ASC-related denials can affect whether a practice is paid for the physician portion of a service. Understanding the CMS clarification and the associated denial indicators helps practices recognize when a claim may need to be re-evaluated.
What You Will Learn
- How ASC place of service affects claim denial handling
- Why professional and facility payment components are treated differently in this setting
- What denial messages may appear on remittance advice and related notices
- How CMS clarification is described in relation to ASC claim processing
Who Should Read This
- Physician practices
- Medical coders
- Medical billers
- Revenue cycle staff
- ASC administrative staff
Codes Discussed
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