US · guidance
CMS Pub. 100-04, ch. 19, § 100.6.1
A/B MAC (A) - ASC - Medicare Part B - Claims Processing
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).
History
(Rev. 1325; Issued: 08-29-07; Effective: 01-01-08; Implementation: 01-07-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5443bf0eb42bf95f29d29f2d65c5cd555645ea5f77dc7de8f690406729c90ad0
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