Ambulatory surgical centers can bill revenue code 0750 for surgical and nonsurgical related services

Ambulatory surgical facilities and centers can bill revenue code 0750 for surgical and nonsurgical related services for Blue Cross Blue Shield of Michigan members.

Nonsurgical procedures reported with revenue code 0750 will no longer require a surgical revenue code and a surgical HCPCS code  to be considered for reimbursement.  

Additional eligible services are being added to specific fee-based categories. Services deemed payable per Blue Cross’ medical and payment policy criteria — and considered appropriate for reporting with revenue code 0750, according to the Centers for Medicare & Medicaid Services — will be allowed reimbursement, effective July 1, 2021.

Refer to the HCPCS Payment Rule Information and Associated Revenue Codes resource for eligible revenue and HCPCS code combinations. To find this information, follow these steps:

1. Access web-DENIS through Provider Secured Services.
2. Click on BCBSM Provider Publications and Resources.
3. Click on Newsletters & Resources.
4. Click on Clinical Criteria & Resources.
5. Scroll down to HCPCS Payment Rule Information and Associated Revenue Codes under Resources.

When checking a code’s payability status for your facility, be sure to access the Facility Claims Information HCPCS Payment Rule Display. This information can be found using the following steps:

1. Access web-DENIS through Provider Secured Services.
2. Click on Facility Claims.
3. Click on HCPCS Payment Rule Display.
4. Enter the HCPCS code.
5. Click on the MPP: Medical Policy Payment Rules button. (This selection will provide a complete list of all valid categories, effective date and pay rules. The PRI, or Payment Rule Inquiry, screen can be accessed by clicking on the HCPCS code applicable to the category and effective date.)

The table below shows the applicable codes.

None of the information included in this article is intended to be legal advice and, as such, it remains the provider’s responsibility to ensure that all coding and documentation are done in accordance with all applicable state and federal laws and regulations.