Ask a Part B News Expert: ASC denials that don't happen in the office

Why This Topic Matters

Site of service can change how a claim is processed and which portion of a service is payable. Understanding the general ASC payment framework and the related Medicare remittance indicators helps practices reduce avoidable denials and verify whether a service is eligible for separate ASC payment.

Article Sections

1. Question and answer on ASC claim denials

   The article presents a billing question about denials in an ambulatory surgery center versus payment in an office setting. It then explains the general payment context for physician and facility claims under CMS rules.

2. CMS ASC payment guidance and approved procedures list

   This section points readers to CMS resources for ASC payment updates and the list of procedures approved for separate ASC reimbursement. It also references Medicare claims processing guidance related to the topic.