PART B REVENUE BOOSTER: Take 5 to Nail Down ASC Coding Rules

Why This Topic Matters

ASC reimbursement depends on using the correct CMS-approved service list and claim modifiers while distinguishing facility billing from physician billing. Understanding these high-level rules helps reduce avoidable claim errors and payment delays.

Article Sections

1. Know where to find ASC-allowed services

   Explains where CMS-related ASC payment information can be found and why access to current and prior quarterly updates matters for billing workflows.

2. Remember the same-day global rule

   Discusses the difference between ASC facility billing and physician billing in relation to same-day global period handling and postoperative return scenarios.

3. Properly append modifier SG

   Covers ASC claim formatting requirements for Medicare and the need to apply the ASC facility modifier consistently across reported services.

4. Discontinued coding modifiers may differ

   Reviews the general distinction between ASC use of reduced or discontinued service modifiers and the alternative outpatient discontinued-procedure modifiers referenced in the article.

5. Keep in contact with the ASC

   Addresses coordination between physician and ASC coding so claims for the same surgery remain consistent before submission.