Benefit from new codes approved for performance in ASCs

Why This Topic Matters

ASC billing rules can affect whether a service is payable, how it is reimbursed, and which entity should receive the claim. Understanding the CMS-approved ASC procedure list and related payment guidance helps avoid denied claims and billing errors.

Article Sections

1. New codes approved for ASC performance

   Introduces the article’s focus on recently added and revised procedure codes relevant to ambulatory surgery center billing. It frames the discussion around pain management services and Medicare ASC approval.

2. ASC billing rules and exclusions

   Summarizes general differences between office, hospital, and ASC billing. It also outlines broad categories of services that are not billable in an ASC setting.

3. Some background

   Provides background on what qualifies as an ASC and how the facility fits into Medicare payment structure. It also discusses changes that took effect with the 2008 ASC payment overhaul.

4. Guidance from CMS

   Describes CMS fact sheet guidance related to ASC payment amounts and reimbursement handling for services outside ASC payments. This section points readers to official CMS resources.

5. Items or Services Not Included in ASC Payments

   Presents an overview of service categories that are excluded from ASC payment and identifies the general billing destination for each category. The section is formatted as a reference chart.