May not be claimed when topical anesthesia only is used.
| Category: | M+ Designated Minor Procedure |
|---|---|
| Base rate: | $288.64 |
| Type | Code | # of calls | Explicit | Action | Amount |
|---|---|---|---|---|---|
| BMI | BMIANE | Yes | Increase By | 25% | |
| BMI | BMIANT | Yes | Increase By | 25% | |
| ROLE | ANE | Yes | Replace Base | $111.49 | |
| ROLE | ANEST | Yes | Replace Base | $18.55 | |
| ANU | ANU | 1 | For Each Call Pay Base At | 100% | |
| ANU | ANU | 2 - 150 | For Each Call Increase By | $18.55 | |
| SURC | EV | Yes | Increase By | $48.70 | |
| SURC | NTAM | Yes | Increase By | $116.83 | |
| SURC | NTPM | Yes | Increase By | $116.83 | |
| SURC | WK | Yes | Increase By | $48.70 |
If a procedure designated "+" is performed in a physician's office, both the procedural benefit and the appropriate office visit benefit for that day may be claimed, but if a consultation benefit pursuant to GR 6.6.4 has been claimed, a visit benefit will not be payable for the day on which the procedure is performed.
If a procedure designated "+" is performed in a place other than a physician's office, either a procedural benefit or a visit benefit, but not both, may be claimed for that day.
If a procedure designated "+" and a consultation are provided on the same day, both the procedural benefit and the appropriate consultation benefit are payable.
If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.
Unless otherwise stated in the schedule, if a surgical procedure and related diagnostic procedure are performed by the same physician, utilizing the same anesthetic, only the greater benefit may be claimed.
Three technical services and three interpretive services from the following examinations may be claimed in addition to HSCs 03.04A, 03.04AZ, 03.08A, 03.08AZ, 03.08H and 09.04:
