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September 2005 · Vol. 17, No. 9

REIMBURSEMENT ADVISER

Is discount unfair for outpatient ablation?

Fast Track

Payment for endometrial ablation depends on place of service

Melanie  Witt,  RN, CPC, MA

Q

Our ObGyn providers perform endometrial ablations in the outpatient department of our local hospital. Medicare and some other major carriers state we are to be reimbursed at the facility fee reimbursement rate. We disagree with this reduction in payment and would like some guidance on how to dispute this discount.

A

The payment level is determined by the place of service, not the category of health care professional performing the surgery.

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