Billing 101: Get Versed in Successfully Handling 3 Compliance Issues for ASCs

Why This Topic Matters

ASC claims can be affected by payer-specific billing preferences, coding conventions, and documentation timing. Understanding these broad compliance areas can help facilities submit cleaner claims and avoid unnecessary rework.

Article Sections

1. Follow these 3 steps to navigate all your claims

   An overview of the article’s three main compliance topics for ASC claims. It introduces the billing and operational issues discussed in the rest of the piece.

2. Step 1: Identify the 5 Methods for Billing Bilateral Procedures

   General discussion of bilateral procedure reporting in the ASC setting and the ways payer preferences can affect claim submission. The section compares common reporting approaches and cites professional and federal guidance at a high level.

3. Step 2: Look for Separate Procedure Status of CPT® Codes

   A broad explanation of separate procedure concepts and the use of distinct-procedure modifiers in relation to same-day services. The section also references documentation support and newer modifier concepts introduced by CMS.

4. Step 3: Don’t Feel Pushed With the Coding Speed

   Operational guidance on claim preparation timing and the risks of submitting incomplete or inaccurate ASC claims. The section emphasizes workflow considerations and the importance of having all needed information before filing.