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Medical Billing and Coding, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, etc.
Viewing:  Sep 19, 2017

ASC Payment Indicator Codes

The icons below are shown on the appropriate CPT® and HCPCS codes.

A2  Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
D5  Deleted/discontinued code; no payment made.
F4  Corneal tissue acquisition, hepatitis B vaccine; paid at reasonable cost.
G2  Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
H2  Brachytherapy source paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
H8  Device-intensive procedure on ASC list in CY 2007; paid at adjusted rate.
J7  OPPS pass-through device paid separately when provided integral to a surgical procedure on ASC list; payment contractor-priced.
J8  Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
K2  Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
K7  Unclassified drugs and biologicals; payment contractor-priced.
L1  Influenza vaccine; pneumococcal vaccine.   Packaged item/service; no separate payment made.  
L6  New Technology Intraocular Lens (NTIOL); special payment.
N1  Packaged service/item; no separate payment made.
P2  Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
P3  Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
R2  Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Z2  Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Z3  Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs.


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