Forum - Questions & Answers
Apr 24th, 2009 - Diane
how to bill to Anthem for charges in an ASC
Our physician did a 55250 and also 11423. Do I need to use any kind of modifier with these two codes when I bill for the ASC charge and also for the professional charge?
Apr 24th, 2009 - nmaguire 2,606
Asc
You will have to call Anthem and check on code 55250 as this describes a Vasectomy and is an elective procedure. If not covered, it is a patient responsibility. If billed by the ASC, it is subject to multiple procedure reduction, where appropriate.
Code 11423 is covered and is paid to ASC based on the MPFS Non-facility Practice Expense RVUs.
Nancy