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Practice Management Clinics

Friday, September 16, 2011
1:00PM - 4:00PM


(C) 113A


Coding and Billing requirements for OMS Ambulatory Surgery Centers

Jeffrey B. Carter, MD, DMD
Medical Director, Ambulatory Surgery Center
Oral Surgical Institute and Specialty Surgery Center
Nashville, TN


The addition of an Ambulatory Surgery Center (ASC) to an OMS practice creates a unique challenge to the administration team. Now, in addition to mastering the CPT-4, CDT-4 and ICD-9-CM and soon ICD-10-CM, the practice must have a commanding knowledge of ASC billing. This lexicon of nomenclature has its origins in Medicare rules and regulations, an area of expertise that is not familiar territory for most OMS offices. The purpose of this course is to introduce the basic building blocks of ASC billing in the context of a single specialty ASC. The workshop is intended for OMS staff that already has a workingknowledge of CPT-4, RBRVS and RUC methodology and NCCI edits.

Learning Objectives

At the conclusion of this presentation, participants should be able to:

  1. Describe the evolution of the ASC billing groups and predict what OMS procedures qualify for facility reimbursement;
  2. Contrast the difference between professional coding and facility coding and recognize the role of modifiers in creating clean claims that satisfy NCCI edits; and
  3. Describe the software specifications for ASC billing and site ASC coding resource materials.

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