HCPro.com: Ambulatory Surgery Coding & Reimbursement Insider

Each month in Ambulatory Surgery and Compliance Reimbursement Insider you get more of our exclusive working tools: model guidelines, policies, forms, etc., that you can use to comply with OIG and HCFA, reduce claim denials, and get paid in full and on time.

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August 2008 (Volume 5, Issue 8)	view entire issue

Review troublesome urology codes, coding practices
Coding and shortcuts rarely go hand in hand. As with any specialty, when coding for urology, coders need to look at the complete operative report to accurately assign the appropriate codes. Some coders might try to take shortcuts by reading through the preoperative diagnosis or the initial operation description at the top of the operative report. However, by doing this, the coder might overlook critical details by referring only to portions of the postoperative note, says Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, an independent consultant based in Maryville, TN.

Take caution with out-of-network billing strategies
Some ASCs might be tempted to exercise an out-of-network billing strategy, but before doing so, carefully consider the pros and cons involved. For example, instead of signing an in-network contract with a preferred provider organization (PPO) with an agreed-upon contractual rate, some ASCs choose to go out of network.In these out-of-network arrangements, the ASC would instead bill the PPO customary charges, which are typically higher than the in-network rates.

Tackle 12 important medical record documentation issues
ASC business offices have a lot to worry about. With so much to keep track of-coding, billing, managed care-it is easy to let something slip off the radar screen. But think again before you let subpar physician documentation slide. Poor documentation can affect an ASC's reimbursement and create compliance risk. For example, if an op report is not detailed enough, it can cause you to underbill procedures, costing your facility revenue. If your physicians use canned op reports, it can lead to a compliance issue with Medicare, meaning Medicare could come back to recoup money.

Other recently-published articles from Ambulatory Surgery Coding & Reimbursement Insider:

Billing rules for devices can be different for each payer

Ambulatory Surgery Coding & Reimbursement Insider 2008 index

Medicare modifiers for ASCs

ASC tackles CFCs to avoid tumult in the future

Be a G whiz: Understand when to assign G codes

Medicare modifiers for ASCs: -50, -52, -58, and -59

Tips to tackle five ASC operational challenges

Understand the billing methods for different types of lenses

Check up on ASCs under the 2008 Medicare payment system

Choose the correct code when reporting SI joint injections

Implement a payment policy and stick to it

Don’t shoot your finances in the foot

ASC 2009 proposed rule holds few surprises

Tackle 12 important medical record documentation issues

Take caution with out-of-network billing strategies

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