A/B MAC (A) - ASC - Medicare Part B - Claims Processing

100.6.1 - A/B MAC (A) - ASC - Medicare Part B - Claims Processing (Rev. 1325; Issued: 08-29-07; Effective: 01-01-08; Implementation: 01-07-08) Charges are reported under revenue code 0360 (operating room services) or 0490 (ambulatory surgical care) on TOB 83X (ambulatory surgical center). ASC surgeries are identified with CPT codes 10000-69979 only. One bill is required for all services provided on the day a surgical procedure is performed. *Exception: Revenue code 0276 (intraocular lenses) and charges may be reported separately to report the intraocular lens for cataract surgeries. The attending/operating UPINs are required in Form Locators 82 and 83 (A-B) on all 83X TOBs. If all surgeries performed are not on the ASC list published in the Federal Register they should not be reported as surgeries, but rather as clinic visits with TOB 13X and revenue code 0510 (clinic). If an admission occurs within 1 day of the ASC services, those charges must be included on the inpatient claim, if the principal diagnosis for admission and those outpatient services are the same. The MSN is suppressed. NOTE: Effective for dates of service on or after January 1, 2008, the A/B MAC (A) no longer processes claims for IHS ASCs. All IHS ASC providers must submit their claims to the A/B MAC (B).