Wednesday, July 20, 2016

Outpatient Surgery CPT code which can performed in ASC

Code Description Comments

10021–19499 Integumentary System/Surgery

20000–29999 Musculoskeletal System/Surgery

30000–32999 Respiratory System/Surgery

33010–37799 Cardiovascular System/Surgery

38100–38999 Hemic and Lymphatic Systems/Surgery

39000–39599 Mediastinum and Diaphragm/Surgery

40490–49999 Digestive System/Surgery

50010–53899 Urinary System/Surgery

54000–58999 Male/Female Genital System/Surgery

59000–59899 Maternity Care and Delivery/Surgery

60000–60699 Endocrine System/Surgery

61000–64999 Nervous System/Surgery

65091–68899 Eye and Ocular Adenexa/Surgery

69000–69999 Auditory System/Surgery

Surgical Centers Billing on a CMS-1500 Form

• For CMS-1500 and electronic 837P, version 5010 billing only, the modifier SG is required (modifier SG is not required for services submitted on a UB-04 or electronic 837I, version 5010).

• Modifier SG is defined as: Ambulatory Surgery Center facility services.

• The modifier SG may be billed in the first or subsequent modifier position (FL 24D) of the CMS 1500 or loop 2400, SV1 segment with appropriate modifier in SV101-2. When applicable, always submit a modifier that reduces the fee schedule/ allowable amount in the primary modifier position, and modifier SG in the secondary position.

Other Information

If applicable, enter the authorization number in Form Locator 63 of the paper UB04 or loop 2300 REF segment with G1 qualifier in REF01 and Harvard Pilgrim authorization number in REF02 of the electronic 837I, version 5010.

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