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reader's question: 03/21/2023

3/21/2023

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Does Medicare require that the surgeon or the physician should also report the ASC as credentialed as place of service? -Morgan from Nebraska
Medicare does have specific guidelines for reporting the place of service for both the surgeon and the Ambulatory Surgical Center (ASC). While the surgeon is not directly responsible for reporting the ASC's credentials, they must correctly report the place of service on their claim forms to ensure proper billing and reimbursement.
According to the Centers for Medicare & Medicaid Services (CMS), the place of service code for an Ambulatory Surgical Center is "24." This code should be used on professional claims submitted by the surgeon to indicate that the services were performed in an ASC setting. The ASC, on the other hand, is responsible for reporting its own credentials and meeting Medicare's requirements for participation.
To ensure compliance with Medicare's regulations, it is essential for both the surgeon and the ASC to correctly report the place of service and maintain proper documentation.
References:
  1. Centers for Medicare & Medicaid Services. (2017). Place of Service Code Set. Retrieved from https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
  2. Centers for Medicare & Medicaid Services. (n.d.). Ambulatory Surgical Centers. Retrieved from https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/ASCs
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    ABOUT THE AUTHOR:
    Ms. Pinky Maniri-Pescasio is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Medical Practice Consultant.

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  • About
  • Services
    • Prior Authorization Services
    • Patient Access Services
    • Surgical Coordination Services
    • Medical Scribe Services
    • Coding and Documentation Audit Review
    • ​E/M & Surgical Coding Education and Training
    • RCM FULL SERVICES
  • READ OUR BLOG
  • Let's Meet in Person
    • 2023 ORTHOPEDIC VALUE BASED CARE CONFERENCE
    • 2023 AAOS Annual Meeting of the American Academy of Orthopaedic Surgeons
    • 2023 ASIPP 25th Annual Meeting of the American Society of Interventional Pain Management
    • 2023 Becker's 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference
    • 2023 FSIPP Annual Conference by FSIPP FSPMR Florida Society Of Interventional Pain Physicians
    • 2023 New York and New Jersey Pain Medicine Symposium
  • Testimonials
  • Frequently Asked Questions and Answers - GoHealthcare Practice Solutions
  • FREE ASSESSMENT
  • Readers Questions