Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 203 - Physician Services
Chapter 4 - Surgery
Rule 23-203-4.1 - Definitions
Universal Citation: MS Code of Rules 23-203-4.1
Current through September 24, 2024
A. For purposes of this chapter Medicaid defines the following terms related to surgery as follows:
1. Add-on codes are procedures performed in
addition to the primary service/procedure and are never reported as a
stand-alone code.
a) Add-on codes describe
additional intra-service work associated with the primary procedure.
b) Add-on codes are exempt from multiple
surgery rules.
2.
Assistant surgeon is a licensed physician who actively assists the physician in
charge of a case in performing a surgical procedure.
3. Bilateral procedures are exact procedures
identified by the same procedure codes which are performed on anatomically
bilateral sides of the body during the same operative session.
4. Co-surgeons are two (2) surgeons, each
usually in a different specialty, who are required to perform specific
procedures during the same operative setting. Co-surgery also refers to
surgical procedures involving two (2) surgeons performing the parts of the
procedure simultaneously, such as bilateral knee replacements.
5. Endoscopic procedure is the performance of
a procedure on interior organs and cavities of the body through an
endoscope.
6. An endoscope is a
flexible fiber optic instrument used to visualize the interior of a body cavity
or organ.
7. Incidental procedure is
a procedure carried out at the same time as a primary procedure, is clinically
integral to the performance of the primary procedure or requires little
additional physician resources.
8.
Multiple deliveries are two (2) or more infants delivered from one (1)
pregnancy.
9. Multiple surgeries are
separate procedures performed by the same physician on the same patient at the
same operative setting. Medicaid applies multiple surgery rules to certain
procedure codes except for certain procedures exempt from multiple surgery
rules.
10. Mutually exclusive
procedures are the separate billing for two (2) or more procedures that are
usually not performed for the same patient on the same date of
service.
11. Team surgeon is a team
of surgeons, more than two (2) surgeons of different specialties, required to
perform a specific procedure.
12.
Unbundled procedures are the use of two (2) or more procedure codes to describe
a procedure or event when a single procedure code exists that comprehensively
describes the surgery performed.
Miss. Code Ann. § 43-13-121
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