What are typical payer expectations for coding and billing in an ASC, including CPT, HCPCS, and APC frameworks?

What are typical payer expectations for coding and billing in an ASC, including CPT, HCPCS, and APC frameworks?

• A. Accurately code procedures with CPT; facility charges using ASC-specific rates and APC-based payments; include anesthesia and implants as applicable; ensure documentation supports codes; avoid duplicate billing; use correct modifiers.
• B. Code procedures using generic codes and submit only facility charges.
• C. Include anesthesia and implants as applicable; ensure documentation supports codes; avoid duplicate billing; use correct modifiers.
• D. Do not use modifiers.

Answer: (C)