July 2013 OPPS HCPCS Code Changes

on Wednesday, 19 June 2013. All News Items | Coding | Billing

The July 2013 Update of the Hospital Outpatient Perspective Payment System (OPPS) includes several new HCPCS codes and some payment revisions to existing codes. Please refer to the following chart for a summary of the additions and changes. All updates are effective July 1, 2013 unless otherwise stated. Please note that HCPCS codes J9002 (Injection, Doxorubicin Hydrochloride, Liposomal, Doxil, 10 mg), J3487 (Injection, Zoledronic Acid (Zometa), 1 mg) and HCPCS code J3488 (Injection, Zoledronic Acid (Reclast), 1 mg) are being replaced with new codes for Medicare billing; these codes are not being deleted and will continue to be accepted by other payers. For more information, see Medicare MLN Matters Article MM8338.

HCPCS Code

Description

Change

SI

C9736

Laparoscopy, surgical, radiofrequency ablation of uterine fibroid(s), including intraoperative guidance and monitoring, when performed

New Service payable under OPPS effective 7/1/2013

T

C9734

Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (MR) guidance

Description modified to include that C9734 must be performed with MR guidance

S

A4648

Tissue marker, implantable, any type

Use A4648 instead of C1879 which is being deleted 6/30/2013

N

0329T

Monitoring of intraocular pressure for 24 hours or longer, unilateral or bilateral, with interpretation and report

New Category III codes effective 7/1/2013

E; not payable under OPPS

0330T

Tear film imaging, unilateral or bilateral, with interpretation and report

New Category III codes effective 7/1/2013

S

0331T

Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment;

New Category III codes effective 7/1/2013

S

0332T

Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment; with tomographic SPECT

New Category III codes effective 7/1/2013

S

0333T

Visual evoked potential, screening of visual acuity, automated

New Category III codes effective 7/1/2013

E; not payable under OPPS

0334T

Sacroiliac joint stabilization for arthrodesis, percutaneous or minimally invasive (indirect visualization), includes obtaining and applying autograft or allograft (structural or morselized), when performed, includes image guidance when performed (e.g., CT or fluoroscopic)

New Category III codes effective 7/1/2013

S

C9131

Injection, ado-trastuzumab emtansine, 1 mg

OPPS Pass-Through Status Effective 7/1/2013

G

Q4122

Dermacell, per square centimeter

OPPS Pass-Through Status Effective 7/1/2013

G

Q2033

Influenza Vaccine, Recombinant Himagglutinin Antigens, for Intramuscular Use (Flublok)

New Code effective 7/1/2013; post FDA approval

L

90686

Influenza virus vaccine, quadrivalent, split virus, preservative free, when administered to individuals 3 years of age and older, for intramuscular use

SI changed from "E" to "L" effective 1/1/2013; post FDA approval

L

Q2050

Injection, Doxorubicin Hydrochloride, Liposomal, Not Otherwise Specified, 10 mg

New code; replaces HCPCS code J9002

K

Q2051

Injection, Zoledronic Acid, Not Otherwise Specified, 1 mg

New code; replaces HCPCS codes J3487 and J3488

K

Q4126

Memoderm, dermaspan, tranzgraft or integuply, per square centimeter

SI changed from "E" to "K" effective 7/1/2013

K

Q4134

Hmatrix, per square centimeter

SI changed from "E" to "K" effective 7/1/2013

K

Article by Debbie Rubio

Debbie Rubio, BS, MT (ASCP), is the Manager of Regulatory Affairs and Compliance at Medical Management Plus, Inc. Debbie has over twenty-seven years of experience in healthcare including nine years as the Clinical Compliance Coordinator at a large multi-facility health system. In her current position, Debbie monitors, interprets and communicates current and upcoming regulatory and compliance issues as they relate to specific entities concerning Medicare and other payers. You may contact Debbie at  This email address is being protected from spambots. You need JavaScript enabled to view it. .

 

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