General Surgeon and Surgical Procedure Identification for

90.4.11.4 - General Surgeon and Surgical Procedure Identification for Professional Services Paid Under the Physician Fee Schedule (PFS) (Rev. 2040, Issued: 08-27-10, Effective: 01-01-11 and 04-04-11, Implementation: 01- 03-11 for the claim identification of the incentive and 04-04-11 for full implementation) Qualifying general surgeons are identified on a claim for a 10 - or 90 - day global surgical procedure based on the primary specialty of the rendering physician, identified by his or her National Provider Identifier (NPI), of 02 - general surgery. If the claim is submitted by a physician group practice, the rendering physician’s NPI must be included on the line-item for the qualifying surgical procedure in order for a determination to be made regarding whether or not the procedure is eligible for payment under the HSIP. Eligible surgical procedures are those procedures for which a 10 - or 90 - day global period is used for payment under the PFS. The specific HCPCS procedure codes eligible for the HSIP are identified in column U (global period) of the Physician Fee Schedule Relative Value Update (RVU) file located at: http://www.cms.gov/Medicare/Medicare- Fee-for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files.html, with a global period designation of 10 - or 90 - days.