6 Critical Things to Know Ambulatory Surgery Center Billing
                     www.ecareindia.com
6 Critical Things to 
Know Ambulatory 
Surgery Center 
Billing & Coding 
Services
Introduction
• Many Providers and healthcare organizations 
partner with experienced medical billing 
companies in the hopes that they would be 
offered ASC billing services as well. 
• However, most US medical billing companies 
lack the skill to process ambulatory surgical 
center billing. 
• ASC medical billing and coding are not like 
processing normal physician billing claims. It 
has so many differences and is quite 
complicated in terms of billing and coding. 
www.ecareindia.com
• As there is room for huge claim denials, the in-
house medical billing team cannot tackle both 
normal and ASC billing independently. 
• Therefore, partnering with an offshore vendor 
that is skilled in Ambulatory surgical center 
billing would be the best solution. 
• In this article, let’s learn about the 6 critical 
things about ASC billing and coding services and 
how offshore vendors help in tacking them:
www.ecareindia.com
Facts about ASC Billing
• In what way ASC medical billing and coding is 
different from normal physician billing? To know the 
answer, first, we have to understand how ambulatory 
surgical centers work.
• According to Medicare, ASC is an independent 
organization that provides outpatient surgical 
services exclusively to its clients.
• Sometimes, it can be run as a part of a huge 
healthcare facility and called as a ‘provider-based 
department of the hospital’. ASC do not provide office 
visits, laboratory services or run diagnostic tests
www.ecareindia.com
New Trends
• To be eligible for reimbursements, Medicare 
expects ASCs to sign up a participating-provider 
agreement with CMS.
• To reduce huge patient bills, CMS is planning to 
make ASCs into ‘bed-less hospitals.’ This way, 
patients can get their surgeries done and 
discharged the same day. 
• They can recuperate at the comfort of their own 
homes by getting in touch with their Providers 
via phone.
www.ecareindia.com
How is Ambulatory 
Surgical Center Billing 
Done?
• Unlike normal physician billing, ambulatory surgical 
centers use a combination of both hospital and 
physician billing
• Most of the ASC billing services are billed using CPT 
and HCPCS Level II codes. However, some insurance 
companies allow ASC services to be billed using 
ICD-9-CM codes
• ASC claims should be filed using the CMS 1500 form 
as per Medicare guidelines
• Medicare also requires the usage of CG modifier to 
distinguish between ASC bill and physician bill
www.ecareindia.com
Approved Surgical 
Procedures
According to CMS, only certain approved 
procedures can be done under an ASC setting. The 
list includes,
• Non-emergency and life-threatening procedures
• Procedures that cannot be done in a physician’s 
office safely
• Elective procedures
• Urgent procedures
www.ecareindia.com
Best Practices to avoid 
Critical Errors
• Some of the best practices to avoid critical errors in 
ambulatory surgical center billing are as follows,
• It is always advisable to read the complete surgical 
report instead of just considering the procedure 
heading while coding
• Sometimes, a procedure started arthroscopically 
might have been changed to an open procedure due 
to complications. It should be considered as an open 
procedure only during billing. Many coders 
mistakenly bill for both procedures, which is wrong
www.ecareindia.com
About e-care India
• For those companies who are on the lookout for 
an experienced ASC billing vendor, e-care India 
will be the prudent choice for 
medical billing services. 
• It has expertise in working for over 25 medical 
specialties and with more than 30 billing 
software, which most billing companies in other 
nations lack. 
• It has all the necessary security certifications 
including the SSAE 18, which is an added 
advantage. 
• To know more about e-care and witwsw s.eecravrieciensd,i al.ocgo m
on to www.ecareindia.com.
Thanks!
Any Queries?
Call us: 1-813-666-0028
Email us: [email protected]
Visit us: www.ecareindia.com