Skip to main content
Share |

Date-of-Service/Historical Search
Select a date from the calendar.
Enter or choose a date. Leave blank to see all historical content for this page.

 
     
 

Ambulatory Surgical Center Billing Requirements

          Fee Schedule (FS) Surgery
          Multiple Fee Schedule Surgery
          Fee Schedule Percent
          Non-Fee Schedule Percent
          Fee Schedule Surgery
          Non-Fee Schedule Surgery
          Multiple Surgery Procedures
          Cap
          Implant
          Fee Schedule (FS) Surgery
          Multiple Fee Schedule Surgery
          Non-Fee Schedule Surgery
     Pre-Surgery
     Post Surgery

General Information

Outlined below are generally accepted billing guidelines. This listing is illustrative only and is not intended to be all-inclusive.

  • Submit one bill to Florida Blue for all services provided on the day or within 72 hours, unless otherwise specified in your contract, of a surgical procedure being performed. This includes all charges for pre-operative testing.
  • No interim or split bills.
  • Include charges for pre-operative testing related to surgery on the same bill as the surgery, whether or not the testing was provided on the date of surgery. The span date should reflect the date of the testing through the date of the surgery. The From Date and Admission Date will be the same if pre-operative services were performed.
  • Submit the date of service on each detail line.
  • CPT or HCPCS codes must be reported on each detail line when the revenue code is one of the codes listed here.
  • Appropriate modifier codes should be reported for accurate application of Correct Coding Initiative (CCI) edits.
  • Bill physician/professional fees on a CMS-1500 form only.

Back to Top

Payment Programs

Florida Blue has two different types of  payment programs for ASCs:

  • ASC Fee Schedule Program
  • Outpatient Fee Schedule Program

Back to Top

ASC Fee Schedule Program

Terminology and Contractual Reference

For payment explanation and illustrative purposes, the following terminology and contractual references are used:

Fee Schedule Percent
  • Refers to the outpatient fee schedule differential as defined in your Agreement.
Back to Top
Fee Schedule Surgery
  • Outpatient fee schedule surgery services will be paid at the rate set forth in your Agreement.
    • Fee schedule amount x fee schedule percent
  • The rate includes payment for the complete course of treatment (e.g. holding room time, operating room time, anesthesia time, recovery room time, all drugs and supplies, laboratory studies, radiology studies, EKG, and other procedures performed.
Back to Top

The ASC Fee Schedule Program is a new payment program in 2012. The new program utilizes sixteen all inclusive surgery categories to determine the allowed amount.  All other services will deny as included in the surgery. Multiple surgery reductions are incorporated in the new program. In addition, the institutional correct coding initiative edits and medically unlikely edits apply to ASC payment programs. Florida Blue will apply outpatient facility edits and not professional edits to ASCs. The base fee schedule is the same for all ASC providers and for all lines of business, but the fee schedule reimbursement is calculated using the negotiated fee schedule percentage that is specific to each line of business. There are no services defined to reimburse at a percent of charges and there is no capped payment under the new program. Implantable devices utilized in the performance of the surgery are not payable to the ASC. They must be obtained through the Implantable Device Procurement Program vendor which is Implant Procurement Group (IPG).

Refer to the ASC Fee Schedule Program to view the surgery groupings and base fee schedule amounts by procedure code. See below for prior versions of the   base fee schedule. 

Back to Top

ASC Fee Schedule Allowance Calculation Examples

Amounts are displayed for illustrative purposes only. These examples demonstrate allowed amount calculations, not the Florida Blue payment because member deductible, coinsurance, and/or copayment liability have not been applied.

For the below examples, the following sample contracted percentage is used:

Fee schedule percent      100% (1.0)
Fee Schedule (FS) Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 24515 Humeral Shaft Fracture FS $591 $800
Total Charges $800

The allowance is determined by:

Fee Schedule Allowance X Fee Schedule Percent = Allowance
24515          $591 X 100% (1.0) = $591

Back to Top

 
Multiple Fee Schedule Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 24515 Humeral Shaft Fracture FS $591 $800
0490 23650 Shoulder Dislocation FS $312 $300
0490 12005 Repair Laceration Scalp FS $419 $500
Total Charges $1600

The allowance is determined by:

Surgical Procedure with the highest fee schedule amount will have an allowance of 100 percent (1.0)
Fee Schedule Allowance X Fee Schedule Percent = Allowance
24515          $591 X 100% (1.0) = $591
Additional procedures will have an allowance of 50 percent (.50) of the applicable fee schedule
23650          $312 X 50% (.50) = $156
12005          $419 X 50% (.50) = $209.50
Total Allowance $956.50

Back to Top

Outpatient Fee Schedule Program

  • OFS reimburses by fee schedule for the majority of outpatient procedures reported, using HCPCS and CPT coding.
  • Covered outpatient services are reimbursed based on fee schedule, percentage of charge, or cap payment methodology, whichever is applicable under the specified Agreement.
  • The FROM DATE is used for all outpatient pricing calculations.
Terminology and Contractual Reference

For payment explanation and illustrative purposes, the following terminology and contractual references are used:

Fee Schedule Percent
  • Refers to the outpatient fee schedule differential as defined in your Agreement.

Back to Top

Non-Fee Schedule Percent
  • Refers to the outpatient non-fee schedule differential as defined in your Agreement.

Back to Top

Fee Schedule Surgery
  • Outpatient fee schedule surgery services will be paid at the rate set forth in your Agreement.
  • The rate includes payment for the complete course of treatment (e.g. holding room time, operating room time, anesthesia time, recovery room time, all drugs and supplies, laboratory studies, radiology studies, EKG, and other procedures performed.

Back to Top

Non-Fee Schedule Surgery

Back to Top

Multiple Surgery Procedures
  • If more than one fee schedule surgery is performed, the surgical procedure with the highest fee schedule amount will be allowed at 100 percent; each additional fee schedule surgical procedure will be allowed at 50 percent of the fee schedule amount.
  • If both non-fee schedule surgery and fee schedule surgery are performed, all surgical procedures will be reimbursed at approved charges multiplied by the non-fee schedule percent.

Bilateral Surgery Billing

A surgery procedure code reported with a 50 modifier (i.e., bilateral procedure) is considered to be two procedures. Bilateral surgery may be reported either on a single line with a 50 modifier or on two separate lines without the 50 modifier.

Examples:

With 50 Modifier

Revenue Code CPT Code Description Charge
0360 19101 50 Biopsy of breast; open, incisional $1,500
Total $1,500

Without 50 Modifier

Revenue Code CPT Code Description Charge
0360 19101 Biopsy of breast; open, incisional $750
0360 19101 Biopsy of breast; open, incisional $750
Total $1,500
Amounts shown are for illustrative purposes only.

Back to Top

Non-Surgical Ancillary Services
  • Fee schedule, non-surgical (ancillary) services are reimbursed at the rate set forth in your Agreement.
  • Non-fee schedule, non-surgical (ancillary) services are reimbursed at approved charges multiplied by the non-fee schedule percent.
  • Non-surgical claims include such services as:
    • laboratory
    • laboratory pathology
    • diagnostic and therapeutic radiology
    • nuclear medicine
    • CT Scans and MRIs
    • emergency room, clinic, treatment room
    • pulmonary function
    • audiology
    • cardiology medicine
    • EKG/ECG
    • EEG
    • medical gastrointestinal services

Back to Top

Cap
  • Cap refers to maximum allowance as defined in your Agreement.
  • Cap payment applies to claims in which all procedures billed are reimbursed at approved charges multiplied by the non-fee schedule percent. The allowance is based on, whichever is less:
  • Cap is applied at the claim level.
  • Cap applies to claims in which all procedures are paid at approved charges multiplied by the non-fee schedule percent.
  • Implants, prosthetics and orthotics are not subject to the cap.

Back to Top

Implant
  • Implant percent refers to the outpatient implantable device differential as defined in your Agreement.
  • Facilities with an agreement to procure implanted devices through a procurement service should follow instructions listed under the Implantable Device Procurement Program and should not include charges for the implanted device when billing Florida Blue.
  • Prosthetics, orthotics, and select implantable devices are reimbursed in addition to covered surgical procedures. Reimbursement is as follows:

    Implants

    • Reported with revenue code 0275 (Pacemaker) or 0278 (Other Implants)
    • Allowance is based on approved charges multiplied by the implant percent.
    • Implants are not subject to the cap.

    Prosthetics and Orthotics

    • Reported with revenue code 0274 (Prosthetic/Orthotic Devices)
    • Allowance is based on approved charges multiplied by the non-fee schedule percent.
    • Prosthetics and orthotics are not subject to the cap.
  • Examples of items not considered for separate payment:
    • cataract lenses

 

Back to Top

Revenue and HCPCS/CPT Codes
 

The following chart identifies revenue codes that require a specific CPT/HCPCS code in field 44 of the UB-04.

  • The type of CPT/ HCPCS codes identified in the right column can only be reported with the revenue code(s) listed in the left column.
  • For example,
    • laboratory procedures must be reported with a laboratory revenue code (0300 - 0309);
    • a surgery CPT code may only be reported with those revenue codes identified and should not be reported with any other revenue code, such as, an anesthesia revenue code (0370).
Revenue Code Description CPT/HCPCS Code
0300 - 0309 Laboratory – Clinical Diagnostic Code for lab procedure performed
0310 - 0319 Laboratory - Pathology Code for pathology procedure performed
0320 - 0329 Radiology - Diagnostic Code for radiology procedure performed
0333 Radiology - Therapeutic Code for therapeutic radiology procedure performed
0340 - 0349 Nuclear Medicine Code for nuclear medicine procedure performed
0350 - 0359 CT Scan Code for CT scan performed
0360 - 0369 Operating Room Services Code for surgery procedure performed
0400 - 0409 Other Imaging Services Code for imaging services, such as, mammography, ultrasound, PET, etc.
0450 - 0459 Emergency Room Code for visit or surgery procedure performed
0460 - 0469 Pulmonary Function Code for pulmonary function procedure performed
0471 Audiology Code for audiology service performed
0480 - 0483 Cardiology Code for cardiology service performed
0490 - 0499 Ambulatory Surgical Care Code for surgery procedure performed
0500 - 0509 Outpatient Services Code for visit or surgery procedure performed
0510 - 0519 Clinic Code for visit or surgery procedure performed
0610 - 0619 Magnetic Resonance Technology (MRT) Code for MRI procedure performed
0730 - 0739 EKG/ECG Code for EKG/ECG procedure performed
0740 - 0749 EEG Code for EEG procedure performed
0750 - 0759 Gastrointestinal Services Code for gastrointestinal service performed
0760 - 0769 Treatment/Observation Room Code for visit
0790 - 0799 Extra-Corporeal Shock Wave Therapy Code for extra-corporeal shock wave therapy procedure performed
0920 – 0925 Other Diagnostic Services Code for diagnostic service performed

(Note: Codes 51736, 51741,51792, 51795, 51797, 54240, 54250, 59020, and 59025 may also be reported using revenue codes 0920 - 0925)

Back to Top

Outpatient Fee Schedule Allowance Calculation Examples
 
Amounts are displayed for illustrative purposes only. These examples demonstrate allowed amount calculations, not the Florida Blue payment because member deductible, coinsurance, and/or copayment liability have not been applied.

For the below examples, the following sample contracted percentages and cap are used:

Fee schedule percent 100% (1.0)
Non-fee Schedule 50% (.50)
Implant Percent 90% (.90)
Cap $1,000

Fee Schedule (FS) Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 24515 Humeral Shaft Fracture FS $591 $800
Total Charges $800

The allowance is determined by:

Fee Schedule Allowance X Fee Schedule Percent = Allowance
24515          $591 X 100% (1.0) = $591

Cap does not apply when surgery is paid by fee schedule.

Back to Top

Multiple Fee Schedule Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 24515 Humeral Shaft Fracture FS $591 $800
0490 23650 Shoulder Dislocation FS $312 $300
0490 12005 Repair Laceration Scalp FS $419 $500
Total Charges $1600

The allowance is determined by:

Surgical Procedure with the highest fee schedule amount will have an allowance of 100 percent (1.0)
Fee Schedule Allowance X Fee Schedule Percent = Allowance
24515          $591 X 100% (1.0) = $591
Additional procedures will have an allowance of 50 percent (.50) of the applicable fee schedule
23650          $312 X 50% (.50) = $156
12005          $419 X 50% (.50) = $209.50
Total Allowance $956.50

Cap does not apply when surgery is paid by fee schedule.

Back to Top

Fee Schedule Surgery with Fee Schedule Ancillaries

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 24515 Humeral Shaft Fracture FS $591 $800
0300 81000 Laboratory FS -- $25
0320 73060 Humerus x-ray FS -- $125
0324 71020 Chest x-ray FS -- $85
0730 93005 EKG FS -- $75
Total Charges $1100

The allowance is determined by:

Fee Schedule Allowance X Fee Schedule Percent = Allowance
24515          $591 X 100% (1.0) = $591
Fee Schedule Ancillaries are included in the surgery allowance.
81000          -- X Included in allowance    
73060          -- X Included in allowance    
71020          -- X Included in allowance    
93005          -- X Included in allowance    
Total Allowance $591

Cap does not apply

Back to Top

Fee Schedule Surgery with Non-Fee Schedule (NFS) Ancillaries

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 46255 Hemorrhoidectomy FS $479 $700
0370   Anesthesia NFS -- $300
0320   Recovery Room NFS -- $150
Total Charges $1150

The allowance is determined by:

Fee Schedule Allowance X Fee Schedule Percent = Allowance
46255          $479 X 100% (1.0) = $479
Ancillary services are included in the surgery allowance.
0370          -- X Included in allowance    
0320          -- X Included in allowance    
Total Allowance $479

Cap does not apply when surgery is paid by fee schedule.

Back to Top

Fee Schedule Surgery with Implant

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 26531 MPJ, Arthroplasty FS $935 $1500
0278   Metacarpophalangeal Joint Implant -- -- $800
Total Charges $2300

Facilities with an agreement to procure implanted devices through a procurement service should follow instructions listed under the Implantable Device Procurement Program and should not include charges for the implanted device when billing Florida Blue.

The allowance is determined by:

Step 1 Fee Schedule Allowance X Fee Schedule Percent = Surgery Allowance
  26531          $935 X 100% (1.0) = $935
Step 2 Approved Charge X Implant Percent = Implant Allowance
  0278          $800 X 90% (.90)   $720
Step 3 Surgery Allowance + Implant Allowance = Total Allowance
  $935 + $720   $1655

Cap does not apply when any procedure is paid by fee schedule.

Back to Top

Non-Fee Schedule Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 10061 I & D Abscess NFS -- $450
Total Charges $450

The allowance is determined by:
The lesser of:
Cap dollar maximum $1,000 or

Approved Charge X Non-Fee Schedule Percent = Allowance
$450 X 50% (.50) = $225

$1000 > $225

Cap does not apply, as the approved charges multiplied by the non-fee schedule percent is the lesser.

Back to Top

Non-Fee Schedule Surgery and Fee Schedule Surgery

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 46255 Hemorrhoidectomy FS $935 $1500
0490 10061 I & D Abscess NFS -- $600
Total Charges $2100

When there is a combination of fee schedule surgery and non-fee schedule surgery, the allowance for all surgeries is based on the charges multiplied by the non-fee schedule percent.

The allowance is determined by:
The lesser of:
Cap dollar maximum $1,000 or

Approved Charge X Non-Fee Schedule Percent = Allowance
$2100 X 50% (.50) = $1050

$1000 < $1050

Cap applies as the cap dollar maximum is the lesser of.

Back to Top

Non-Fee Schedule Surgery with Implant

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 33216 Replacement of Pacemaker Pulse Generator NFS -- $2200
0275 L8499 Pacemaker -- -- $3500
Total Charges $5700

Facilities with an agreement to procure implanted devices through a procurement service should follow instructions listed under the Implantable Device Procurement Program and should not include charges for the implanted device when billing Florida Blue.

The allowance is determined by:

Step 1 Surgery Allowance
The lesser of:
Cap dollar maximum $1,000 or
  Approved Charge X Non-Fee Schedule Percent = Surgery Allowance
  $2200 X 50% (.50) = $1100
      $1,000 < $1,100
Cap applies
Step 2 Implant Allowance
  Implant Charge X Implant Percent = Implant Allowance
  $3500 X 90% (.90)   $3150
Step 3 Total Allowance
  Surgery Allowance + Implant Allowance = Total Allowance
  $1000 + $3150   $4150

Back to Top

Non-Fee Schedule Surgery with Fee Schedule and Non-Fee Schedule Ancillaries

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 10061 Replacement of Pacemaker Pulse Generator NFS -- $450
0370   Anesthesia NFS -- $125
0300 85025 CBC FS $20 $85
Total Charges $660

The allowance is determined by:

Step 1 Approved Charges X Non-Fee Schedule Percent = Non-Fee Schedule Allowance
  10061          $450 X 50% (.50) = $225
  0370           $125 X 50% (.50) = $62.50
  $287.50
Step 2 Fee Schedule Allowance X Fee Schedule Percent = Fee Schedule Allowance
  85025          $20 X 100% (1.0)   $20
Step 3 Non-Fee Allowance + Fee Schedule Allowance = Total Allowance
  $287.50 + $20   $307.50

Cap does not apply when any procedure is paid by fee schedule.

Back to Top

Fee Schedule and Non-Fee Schedule Surgeries with Fee Schedule Ancillary

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 46255 Hemorrhoidectomy FS $635 $700
0490 10061 I & D Abscess NFS -- $450
0300 81000 Laboratory FS $15 $50
0324 71020 Chest X-ray FS $25 $75
Total Charges $1275

When there is a combination of fee schedule surgery and non-fee schedule surgery, the allowance for all surgeries is based on the charges multiplied by the non-fee schedule percent.

The allowance is determined by:

Step 1 Approved Charges X Non-Fee Schedule Percent = Non-Fee Schedule Allowance
  46255          $700 X 50% (.50) = $350
  10061          $450 X 50% (.50) = $225
  $575
Step 2 Fee Schedule Allowance X Fee Schedule Percent = Fee Schedule Allowance
  81000          $15 X 100% (1.0)   $15
  71020          $25 X 100% (1.0)   $25
  $40
Step 3 Non-Fee Allowance + Fee Schedule Allowance = Total Allowance
  $575 + $40   $615

Cap does not apply when any procedure is paid by fee schedule.

Back to Top

Fee Schedule and Non-Fee Schedule Surgeries with Non-Fee Schedule Ancillary

Revenue Code CPT Code Description Schedule Type Schedule Allowance Charge
0490 46255 Hemorrhoidectomy FS $935 $1500
0490 10061 I & D Abscess NFS -- $450
0270 -- Med-Surg Supplies NFS -- $125
Total Charges $2075

When there is a combination of fee schedule surgery and non-fee schedule surgery, the allowance for all surgeries is based on the charges multiplied by the non-fee schedule percent.

The allowance is determined by:
The lesser of:
Cap dollar maximum $1,000 or

Approved Charges X Non-Fee Schedule Percent = Allowance
$1500 X 50% (.50) = $750
$450 X 50% (.50) = $225
Total $1037.50

$1000 < $1037.50

Cap applies because all lines are reimbursed by charges multiplied by non-fee schedule percent.

Back to Top

Implantable Device Procurement Program for ASCs

Effective January 1, 2010, an Implantable Device Procurement Program was implemented and rolled out in a phased approach to all ASC networks. The program provides for the implementation of a new statewide implant device provider, Implantable Provider Group, and includes changes in the ASC reimbursement model for implantable devices.

This program applies to all lines of business with the exception of Medicare Private Fee-for-Service and Medicare Supplement.

IPG is the required resource for procuring, coordinating, billing, replacing and tracking implantable devices. ASCs will no longer bill Florida Blue for implantable devices used in surgeries. These devices will be billed to Florida Blue by IPG who will coordinate the device procurement process with you.

IPG is only providing device procurement services to contracted providers. Coverage under the member’s benefit plan will be determined by Florida Blue.

Note: IOLs are excluded from the Implantable Device Procurement Program. ASCs should continue to supply and bill for IOLs under revenue code 276.

Process for Obtaining Implantable Devices from IPG

Complete an IPG New Account Form available at www.ipgsurgical.com/forms. This is a one-time process, which allows loading into the IPG system.

For questions on completing the form, participating providers should contact IPG.

Back to Top

Pre-Surgery
  1. The ASC or the physician’s office fax’s the completed Patient Information Form to IPG at (866) 295-4773. You may substitute an existing Patient Demographic Form for IPG’s Patient Information Form providing your version contains the same information as required on the IPG form. If you choose this option, please have IPG review your format to confirm that it will work.
  2. Forms are available at www.ipgsurgical.com/forms.
  3. IPG confirms receipt via phone or email.
  4. IPG begins benefit verification process.

Back to Top

Device Approval and Scheduling
  1. IPG provides written notification of acceptance via fax or email.
  2. IPG sends a fax or email to the ASC confirming approval of the procedure.

Back to Top

Representative Delivery

(Manufacturer Representative brings implantable device to ASC)
  1. Scheduling and Ordering: ASC schedules procedure and calls Manufacturer Representative to deliver device. ASC notifies IPG of procedure.
  2. Delivery: Contracted Manufacturer Representative delivers implantable device to ASC.
  3. Post Surgery: Manufacturer provides IPG with Implant Charge Sheet with administrator or physician’s signature and affixed implant stickers to IPG via fax at (866) 295-4773 within three days of the implant surgical procedure.

    Note: Equipment lists with physician’s signatures submitted directly to ASC from Manufacturer Representative must be forwarded to IPG. IPG will not reimburse facility directly for implants.

  4. Purchase: IPG issues Purchase Order to Manufacturer.
  5. Billing and Payment: Manufacturer bills IPG directly. ASC has no financial responsibility for the implantable device.

Back to Top

Tissue Implant/Drop Ship Just-In-Time for Surgery
  1. Scheduling: Physician’s office schedules procedure with ASC.
  2. Purchase Order: Physician’s office or facility obtains Tissue Request Form from IPG (available at www.ipgsurgical.com/forms). IPG then issues the physician’s office or facility a PO for the ordering of the implantable tissue.
  3. Ordering: Physician’s office or facility orders implantable tissue from Contracted Tissue Bank.
  4. Delivery: Tissue Bank ships implantable tissue to ASC.
  5. Post Surgery: ASC must submit an Implant Charge Sheet with administrator or physician’s signature and affixed implant stickers to IPG via fax at (866) 295-4773 within three days of the implant surgical procedure.
  6. Billing and Payment: Tissue Bank bills IPG directly. ASC has no financial responsibility for the implantable tissue.

Back to Top

Purchased Inventory – ASC Maintains Inventory of Implants
  1. Scheduling: ASC schedules and performs procedure using implantable device from purchased inventory.
  2. Post Surgery: ASC submits an Implant Charge Sheet with administrator or physician’s signature and affixed implant stickers to IPG via fax at (866) 295-4773 within three days of the implant surgical procedure.
  3. Purchase: IPG provides ASC a PO allowing the ASC to order replacement items used in surgery.
  4. Billing and Payment: Contracted Manufacturer bills IPG directly. ASC has no financial responsibility for the implantable device.
  5. Delivery: Manufacturer ships implantable device directly to ASC to replenish the item used in surgery.

Back to Top

Consigned Shelf Stock – ASC Maintains Shelf Stock of Implants
  1. Ordering: Manufacturer Representative provides sufficient stock of implants for shelf stock.
  2. Post Surgery: ASC submits an Implant Charge Sheet with administrator or physician’s signature and affixed implant stickers faxed to IPG via fax at (866) 295-4773.
  3. Purchase Order: IPG will provide PO to contracted Manufacturer Representative.

    Note: If ASC manages shelf stock, IPG will provide the ASC with a PO for ordering replenishment shelf stock from the contracted MFG.

  4. Billing and Payment: Contracted Manufacturer bills IPG directly. ASC has no financial responsibility for the implantable device.
  5. Delivery: Manufacturer Representative manages shelf stock levels/replenishment of consigned devices.

Back to Top

Post Surgery

As noted above, to confirm the implants used in the surgical procedure, the ASC is required to forward a signed Implant Charge Sheet with administrator or physician’s signature and affixed implant stickers to IPG within three days of the implant surgical procedure via fax at (866) 295-4773.

Receipt of the Implant Charge Sheet initiates the claim submission process for reimbursement of the implant to IPG. Therefore, it is critically important that the ASC comply with this process. Failure to complete this final step in the process will prevent IPG from ordering replacement implants.

Back to Top

IPG Non-Contracted Manufacturers

If a participating provider wishes to order an implant device from a manufacturer that is not yet contracted with IPG, contact IPG.

Back to Top

7/16/2014
The Manual is not intended to be a complete statement of all BCBSF polices or procedures for providers. Other policies and procedures, not included in this Manual, may be posted on our website or published in special publications, including but not limited to, letters, bulletins, or newsletters. Any section of this Manual may be updated at any time. In the event of any inconsistency between information contained in this Manual and the agreement(s) between you or your facility and BCBSF or Health Options the terms of such agreement(s) shall govern.

The Manual is not intended to be a complete statement of all Florida Blue polices or procedures for providers. Other policies and procedures, not included in this Manual, may be posted on our website or published in special publications, including but not limited to, letters, bulletins, or newsletters. Any section of this Manual may be updated at any time. In the event of any inconsistency between information contained in this Manual and the agreement(s) between you or your facility and Florida Blue or Health Options the terms of such agreement(s) shall govern.

Refer to the References section to view all applicable copyrights, registered trademarks, service marks, and/or references. Acronyms are also defined in the References section.

Internet Privacy Statement

© 2012 Florida Blue is a trade name of Blue Cross and Blue Shield of Florida Inc., an Independent Licensee of the Blue Cross and Blue Shield Association.