ASC Coding, Billing & Collections

CMS finalized the 2022 ASC payment rules and approved procedures list on Nov. 2, with 255 procedures removed from the outpatient surgery list.

ASCs are recognized by many payers as high-quality, cost-effective sites of service, but some centers are still struggling to secure reimbursements. 

The 32BJ Health Fund, the health benefits organization for a service workers' union branch, and the New York City-based Mount Sinai Health System expanded their Centers of Excellence program to include two ASCs, according to a Nov. 1 news release.

Nine ASC leaders spoke with Becker's ASC Review about the biggest obstacles they face with private payers, from implant costs to declining reimbursements. 

Ambulatory Surgical Center of Stevens Point (Wis.) is teaming up with Trilogy Health for workers compensation cost containment, the company said Oct. 26. 

The Office of Inspector General found CMS overpaid $636 million for neurostimulator implantation surgeries between 2016 and 2017, according to an audit of outpatient hospital and ASC claims. 

Five updates from Aetna, an insurer serving about 39 million customers nationwide, in the last 60 days:

Springfield (Ill.) Clinic warned 100,000 Blue Cross and Blue Shield of Illinois-covered patients that they could lose access to their doctors, The State Journal-Register reported Oct. 15. 

Melbourne, Fla.-based Surgery Center of Viera sued Aetna on Oct. 13, according to court documents. The lawsuit alleges that Aetna used an undisclosed "mystery repricing program" to reimburse Viera $33,380 for a July 2018 spinal procedure that the ASC says cost…

Gil Tepper, MD, founder and CEO of Prime Surgeons in Los Angeles, spoke with Becker's ASC Review on changes he feels CMS should implement to give hospital outpatient departments and ASCs equal footing.