When an outpatient visit is billed and it is not an ASC bill and not an ER bill, if there are charges for EKG, can they be paid at fee schedule plus 10%?
Yes. When the patient goes to the hospital as outpatient for a myelogram and they charge a fee for revenue code 360 or 361 and bill for the injection for the myelogram, that should be denied and the other charges paid as separate outpatient x-ray and lab. Is this correct? Yes, deny 360 or 361. Pay S & I to hospital, and pay lab as separate outpatient. The technical portion of the procedure pays for use of the facility. Also, pay for the injection. I need to know if we should be paying a 23-hour surgery differently from an outpatient surgery. I have been paying them as the same but have been asked about why I do not pay observation charges in addition to the surgery. Which is correct? It is an outpatient surgery as long as it is under 24 hours. The definitions of observation are listed in the fee schedule. It states that we do not pay observation on standing orders. If you are referring to the calls from Methodist Rehab Center, this is nothing but outpatient surgery with standing orders
