Medicare Claims Processing Manual (Pub. 100-04), Ch. 26 § 10.8.1

Assigning Specialty Codes by A/B MACs (B) and DME MACs

Length: 105 wordsOfficial source
10.8.1 - Assigning Specialty Codes by A/B MACs (B) and DME MACs Physicians are allowed to choose a primary and a secondary specialty code. If the A/B MAC (B) and DME MAC provider file can accommodate only one specialty code, the A/B MAC (B) or DME MAC assigns the code that corresponds to the greater amount of allowed charges. For example, if the practice is 50 percent ophthalmology and 50 percent otolaryngology, the A/B MAC (B)/DME MAC compares the total allowed charges for the previous year for ophthalmology and otolaryngology services. They assign the code that corresponds to the greater amount of the allowed charges.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 26 § 10.8.1: Assigning Specialty Codes by A/B MACs (B) and DME MACs | Justis AI