New Drug Codes, Category III Codes in July OPPS Update

on Monday, 30 July 2012. All News Items | Outpatient Services | Coding

CMS recently released the July 2012 Update of the Hospital Outpatient ProspectivePayment System. The update includes six new drug HCPCS codes for reporting in the hospital outpatient setting effective for services furnished on or after July 1, 2012. The new drug codes are:

 

New HCPCS CodeLong DescriptorReplaces CodeOld Descriptor
Q2045 Injection, human fibrinogen concentrate, 1 mg J1680 Injection, human fibrinogen concentrate, 100 mg
Q2046 Injection, aflibercept, 1 mg C9291 Injection, aflibercept, 2 mg vial
Q2047 Injection, Peginesatide, 0.1 MG (for ESRD on Dialysis) NA  
Q2048 Injection, doxorubicin hydrochloride, liposomal, doxil, 10 mg J9001 Injection, doxorubicin hydrochloride, all lipid formulations, 10 mg
Q2049 Injection, doxorubicin hydrochloride, liposomal, imported lipodox, 10 mg NA  
Q2034 Influenza virus vaccine, split virus, for intramuscular use (Agriflu) NA  

Three of the new codes replace other codes; the replaced codes will either be deletedor no longer payable by Medicare effective July 1, 2012. Note that Q2045 and Q2046 have different unit descriptions than the codes they are replacing. Hospitals need to be diligent to ensure quantities are reported correctly utilizing the new descriptor units.
Also included in the July transmittal is a listing of Category III CPT Codes implemented as of July 1, 2012:
CPT CodeLong Descriptor
0302T Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when performed; complete system (includes device and electrode)
0303T Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when performed; electrode only
0304T Insertion or removal and replacement of intracardiac ischemia monitoring system including imaging supervision and interpretation when performed and intra-operative interrogation and programming when performed; device only
0305T Programming device evaluation (in person) of intracardiac ischemia monitoring system with iterative adjustment of programmed values, with analysis, review, and report
0306T Interrogation device evaluation (in person) of intracardiac ischemia monitoring system with analysis, review, and report
0307T Removal of intracardiac ischemia monitoring device
0308T (replaces C9732) Insertion of ocular telescope prosthesis including removal of crystalline lens
 
Readers can view complete information at MLNMatters Article MM 7847.

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