Medicare Advantage Preferred Provider Organization (MA PPO)

Applicable to enrollees from other Blue Cross Blue Shield Medicare Advantage Plans who obtain health care services within the 5-county Philadelphia service area.

Policy Attachment

Attachment to Policy #

MA00.031f

Attachment:

Policy #:

MA00.031f

Description:

Codes eligible for reimbursement when billed by Hand Surgeons, Orthopedic Surgeons, Sports Medicine, Pediatric Sports Medicine, or Orthopedic Sports Medicine Specialists

Title:

X-rays Associated with Fractures in the Office Setting

X-RAYS ASSOCIATED WITH A FRACTURE THAT ARE ELIGIBLE FOR FEE-FOR-SERVICE REIMBURSEMENT

WHEN BILLED BY A HAND SURGEON, AN ORTHOPEDIC SURGEON, A SPORTS MEDICINE, A PEDIATRIC SPORTS MEDICINE, OR AN ORTHOPEDIC SPORTS MEDICINE SPECIALIST,

(THIS INCLUDES CERTIFIED REGISTERED NURSE PRACTITIONERS (CRNPs) AND PHYSICIAN ASSISTANTS (PAs) PRACTICING WITHIN THESE SPECIALTY GROUPS),

WHEN THE CRITERIA IN THE POLICY ARE MET

NOTES:

The Effective Date indicates either the date the code became effective and/or the date the code became eligible for fee-for-service reimbursement consideration.

The Delete Date indicates either the date the code becomes invalid and/or the date the code is no longer eligible for fee-for-service reimbursement consideration.

Claims will be considered for fee-for-service reimbursement when a hand surgeon, an orthopedic Surgeon, a sports medicine, pediatric sports medicine, or orthopedic sports medicine specialist reports a listed procedure.

CPT CODE	EFFECTIVE DATE	DELETE DATE
73000	5/27/2011
73020	5/27/2011
73030	5/27/2011
73050	5/27/2011
73060	5/27/2011
73070	5/27/2011
73080	5/27/2011
73090	5/27/2011
73092	5/27/2011
73100	5/27/2011
73110	5/27/2011
73120	5/27/2011
73130	5/27/2011
73140	5/27/2011
73551	1/1/2016
73552	1/1/2016
73560	5/27/2011
73562	5/27/2011
73564	5/27/2011
73565	5/27/2011
73590	5/27/2011
73592	5/27/2011
73600	5/27/2011
73610	5/27/2011
73620	5/27/2011
73630	5/27/2011
73650	5/27/2011
73660	5/27/2011

Version Effective Date:

12/05/2022

Version Issued Date:

12/05/2022

Version Reissued Date:

06/26/2024

Medicare Advantage Preferred Provider Organization (MA PPO)

Applicable to enrollees from other Blue Cross Blue Shield Medicare Advantage Plans who obtain health care services within the 5-county Philadelphia service area.

Notification

Policy Attachment