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June 1, 2015

Claim Adjustment for CPT code 00810

CMS recently notified Medicare Administrative Contractors (MACs) that the Part B claims processing system will be updated to allow previous denials for anesthesia CPT code 00810 when:

  • submitted with HCPCS modifier PT; and
  • submitted with CPT modifier 33 when there was no screening colonoscopy HCPCS codes G0105 or G0121 in the beneficiary's history.
  • The Medicare deductible and co-insurance will be waived.

This update is for dates of service on or after January 1, 2015.

No action is required of you. CGS will adjust denied claims submitted as indicated above within 45 calendar days.

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