Q&A: Stark and Billing Issue Concerns With Sharing an IOL Between Surgery Centers

Q: If a doctor has ASC(A) order an IOL but then takes the IOL to ASC(B) for the surgery, can ASC(B) pay ASC(A) back the invoice price for the IOL without any Stark or billing issues?

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Judie English of Serbin Surgery Center Billing:
According to a source very familiar with regulatory issues, this is not so much a Stark issue but a contract issue with ASC (A)’s vendor. Most contracts have a clause that says the ASC cannot resell the IOLs. Additionally, the serial numbers are tracked to the ASCs that they are either (1) sold to or (2) consigned to.

If this is an emergency and occurs only once, make sure the IOL serial number is copied, as well as the diopters and type, and notify the company that it was used by another ASC in an emergency. When the second ASC receives their next order, they replace the IOL, giving the company the serial number of the one they send back for tracking, etc.

ASC(A) might be paying $50 and ASC(B) might be paying $75 and this is where the big issue and breach of contract starts as well as the requirements for tracking of sale and patient use of implantable devices.

Serbin Surgery Center Billing concentrates on the unique needs of surgery centers and offers expert and accurate coding, billing and collections solely to the ASC industry. Learn more by calling (866) 889-7722.

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