Revenue Code 0710 (Recovery Room) Billing Requirements
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Defines Blue KC's billing and payment requirements for facility reporting of revenue code 0710 (Recovery Room/PACU) for surgical procedures for facilities not using CMS reimbursement methodology; affects facility claims across Blue KC lines of business.
Policy language changed to require an anesthesia revenue code (037X) be billed with recovery room revenue code 0710.
Previously specified time range requirement for recovery room billing was removed.
Recovery Room (0710) Coverage Criteria
Recovery Room (0710) coverage criteria
Coverage and billing criteria for revenue code 0710 (Recovery Room):
ALL of the following
- This policy applies to surgical procedures submitted by facilities not contracted to use CMS reimbursement methodology.
Coding and Billing Constraints
| 0710 | Recovery Room - General Classification |
| 037X | Anesthesia Services (valid 37x revenue code required) |
Provider Billing Requirements and Actions
Prior authorization / claim submission requirement for 0710
Report revenue code 0710 (Recovery Room) on the day of the surgical procedure and only when billed together with a valid anesthesia revenue code in the 37x series; claims that include 0710 without a 37x will be denied as incomplete or incorrect.
- 0710 must be billed in conjunction with a valid 37x anesthesia revenue code.
- Claims with 0710 submitted without a 37x will be denied due to incomplete or incorrect data.
- 0710 is allowed only on the day of surgery/procedure.
Definitions
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