ASC billing
Ophthalmology ASC Billing: Professional and Facility
An ophthalmology surgery case produces at least two claims, the surgeon's and the center's, under different payment rules. LMC bills both so they describe the same case the same way.
Why ASC billing is different
Two claims, two rulebooks, one case.
Facility Payment Rules
ASC claims follow facility payment methodology, with packaged services, payment indicators, and device or implant rules the surgeon's claim never sees.
Multiple and Bilateral Procedures
Second-eye surgery, multiple procedures, and modifier logic affect facility and professional payment differently.
Noncovered Refractive Services
Premium IOL and refractive upgrade charges must be split correctly between surgeon and facility. See cataract billing.
Scheduling to Billing Handoff
Authorizations and benefit checks made at scheduling decide whether the facility claim pays.
How LMC helps
Coordinated surgeon and center billing.
Pre-Surgery Verification
Eligibility, benefits, and authorizations confirmed for both the surgeon and the facility.
Matched Claims
Professional and facility claims reviewed together for consistent codes, modifiers, and laterality.
Center-Level Reporting
Case-level visibility into payment, denials, and A/R for the ASC and the practice.
FAQ
ASC billing questions.
Can LMC bill for our ASC if it is separate from the practice?
Yes. LMC supports facility billing for ophthalmology ASCs whether the center is practice-owned or a separate entity.
Do you only bill for the facility, or the surgeon too?
Both. Billing professional and facility claims together is where most coordination problems are solved.
Which ASC systems do you work with?
LMC works within the systems your center already uses. Ask about your specific system during your revenue review.
Get your surgeon and facility claims telling the same story.
Request a Revenue ReviewRelated: Cataract Billing · Retina Billing · All Services