ASC Coding

View Sample Report: ASC Audit

Coding for Ambulatory Surgery Centers is a specialty unto itself. It is a facility service, but Medicare requrires ASC’s to send their bills to the professional fee (Part B) payers, but using the facility fee (Part A) claim form. There is a whole different set of regulations and bundling edits to use for ASCs. Many ASCs use the same codes as the surgeons, but that can be a revenue “kiss of death” and create compliance exposure for every shareholder-or-partner in the ASC. The rules of the game are different for ASCs than for surgeons or for hospitals; at times ASCs must follow the rules for doctors, and at other times they must adhere to the hospital’s rules. A simple modifier used incorrectly can deliver a “fatal blow” to an otherwise clean claim for thousands of dollars. A article in Ocular Surgery News likened ASC coding to learning how to drive on the left side of the road; it is counterintuitive and fraught with danger.

Many ASCs are partially owned and managed by national ASC development and management companies. We code for quite a few, offering them a consistent level of coding accuracy and responsiveness across all of their locations. Some of their ASCs are located in smaller cities and communities that don’t have deep labor pools for experienced ASC coders. With HIPAA-compliant document management and remote access to electronic medical records, we can code for those ASCs as easily as if we were at the next desk.

One of the key services we offer is auditing the accuracy of coding done by others. For the last few yearts, the national and state ASC conferferences have been well attended by exhibiting coding and billing companies that send the bulk of their back-office functions, including coding, to contractors in India and other foreign countries. They advertise both cheap prices and that your coding will be done by doctors and nurses over there. On the basis of our audits of the accuracy of their coding, The Coding Network, LLC has made the strategic decision not to use any offshore coding. TCN’s network of coders exclusively live-and-work in the United States of America.

ASC Coding Background

  • Directed by a nationally renowned ambulatory surgical center coding and reimbursement expert who is a certified coder and a frequent lecturer at national conferences.
  • Decades of experience coding for ambulatory surgical centers.
  • Named to Becker’s list of the “Top 40 Women in ASC’s
  • Frequent speaker at state, regional, and national ASC conferences.
  • Expert witness on ambulatory surgical center coding fraud and abuse.
  • Author of numerous articles on ambulatory surgery center coding.
  • Expert on ambulatory payment classification (APC) system and ambulatory patient groups (APG’s).

ASC Coding Need

  • Well trained ambulatory surgical center coders for are hard to find.
  • Few ambulatory surgery center coders are certified, and few certified coders have ambulatory surgery center experience.
  • Ambulatory surgery center coding guidelines are complex, change often and are different than those for physicians; codes and modifiers that work for physicians are not always acceptable for ambulatory surgery centers.
  • Coder turnover, vacations, and family leaves create cash flow peaks and valleys.
  • With so few coders specializing in this niche, it is difficult to find and hire experienced ambulatory surgery coders, even in large metropolitan areas. ASC’s in smaller communities and tight labor markets have trouble filling openings.
  • The wide range of specialties represented at ASC’s are beyond most coders’ capabilities.

ASC Coding Solution

  • TCN ‘s ambulatory surgical center coding services gives you immediate access to certified coders, experienced in ambulatory surgery center coding, who have passed very rigorous competency tests, and who are monitored by a Q/A program.
  • All of your coding will be performed in the United States of America. We’ve never used offshore coders.
  • Have your ASC’s cases coded, within 2-to-3 work days if sent on a consistent basis.
  • Send us cases by FedEx/UPS, fax, or electronically. We can HIPAA compliantly remotely access your EMR and systems.
  • We will identify your surgeons’ documentation deficiencies to help improve the quality of your medical records and optimize reimbursement.
  • Our per-case pricing model is often less expensive than performing the work in-house.
  • You have a whole team of coders with The Coding Network.
  • ASC coder turnover creates cash flow peaks and valleys.

ASC Coding Services

  • Ongoing ambulatory surgical center coding coverage for all or part of your caseload.
  • Temporary ambulatory surgical center coding coverage for vacations and sick leave.
  • Second opinion coding services.
  • Backlog coding resolution services.
  • Compliance “peer” reviews.
  • Physician documentation training.
  • Physician documentation deficiency reporting.
  • ASC Coding “helpline” services.
  • OIG and RAC audit defense.

View Sample Report: ASC (2) Audit

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