Removal of Device Portion from Certain Discounted Device-

40.10 - Removal of Device Portion from Certain Discounted Device- Intensive Ambulatory Surgical Center (ASC) Procedures Prior to the Administration of Anesthesia (Rev.11793; Issued:01-19-23; Effective: 02-21-23; Implementation: 02-21-23) Effective for claims with dates of service beginning January 1, 2016, contractors will identify and process device intensive procedures and services billed with the 73 modifier, by utilizing the program payment amount appearing in the FB Mod Reduced Price field on the ASCFS record layout as the full program payment, with the device portion removed, prior to processing the 73 modifier payment calculations. If there is no payment amount in the FB Mod Reduced Price field of the ASCFS, then the procedure is not device intensive and this new policy would not apply. To process claims correctly, when device intensive procedures and services are billed with the 73 and FB/FC modifiers, the FB/FC modifier is ignored for this line item unused device, and the line item would continue to be processed as stated above. For ASCs subject to the Ambulatory Surgical Center Quality Reporting (ASCQR) Program payment reduction, contractors shall utilize the procedure payment amount located in the respective Penalty FB Mod Reduced Price field on the ASCFS in place of the payment amount in the FB Mod Reduced Price field or the Penalty Price field on the ASCFS in place of the payment amount in the Price field, as appropriate.