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Issue Number - Name
0050 - Add-on Codes Paid without Primary Code and/or Denied Primary Code
Review Type
Automated
Claim Type
Physician, Professional Services/Outpatient Hospital Services
Region and State
RAC 1-4
All States
Date Approved
2017-04-11

Description

CPT has designated certain codes as "add-on procedures." These services  are always done in conjunction with another procedure and are only payable when an appropriate primary service  is also billed.

Affected Code(s)

  • Add-on Codes List

Applicable Policy References

  • Social Security Act, Section 1833 [42 U.S.C. 1395l] (e)
  • CMS Pub. Medicare Claims Processing Manual, Chapter 12, Section 30 D
  • CMS Pub. Medicare Claims Processing Manual, Chapter 01, Section 70;
  • CMS Pub. Medicare Claims Processing Manual, Chapter 16, Section 40.8
  • CMS Pub. Medicare Claims Processing Manual, Chapter 29, Section 240