Covered Surgical Procedures
Covered surgical procedures are procedures that meet the following criteria:
• Surgical procedures commonly performed on an inpatient basis in hospitals but may be safely performed in an ambulatory surgical center setting
• Surgical procedures limited to those requiring a dedicated operating room and generally requiring a post-operative recovery room or short-term (not overnight) convalescent room
• Surgical procedures not otherwise excluded under 42 C.F.R. § 416.65 or other regulatory requirement
• Procedure codes within the range of 10000-69XXX
Medicaid maintains a listing of the covered surgical procedures in Appendix I, ASC Procedures List. This list is reviewed and updated on a quarterly basis. Providers should refer to the fee schedule before scheduling outpatient surgeries since some procedures are restricted to recipients under age 20 and others may require prior authorization.
Ambulatory surgical center billing code guidelines and how to get payment from insurance. ASC denial, CPT CODES , Authorization and referral Guide. Multiple procedure, Surgical procedure tips. What to get the correct reimbursement in ASC billing setup. SNF billing Guide, tips to use correct CPT AND POS.
Thursday, November 11, 2010
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