The Only Thing Constant is Change
I wouldn’t be surprised if this saying is posted on a CMS bulletin board somewhere, because they certainly practice it. The challenge for healthcare providers is keeping up with all the changes and responding with needed actions when required.
As usual, the quarterly update to the Outpatient Prospective Payment System (OPPS) contained a number of payment adjustments for HCPCS codes. Please see the table below for a summary of the changes.
HCPCS |
Effective date |
SI |
Long descriptor |
Change |
|---|---|---|---|---|
| C9739 | 4/01/2014 | T | Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants | New service payable under OPPS |
| C9740 | 4/01/2014 | T | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | New service payable under OPPS |
| C9021* | 4/01/2014 | G | Injection, obinutuzumab, 10 mg | OPPS Pass-Through Status |
| Q4121 | 4/01/2014 | G | Theraskin, per square centimeter | OPPS Pass-Through Status |
| A9545 | 4/1/2014 | E | Iodine I-131 tositumomab, therapeutic, per treatment dose | Status Indicator change (from K to E) |
| J1446 | 1/1/2014 | K | Injection, TBO-Filgrastim, 5 micrograms | Status Indicator change (from E to K) |
| J7178 | 1/1/2014 | K | Injection, human fibrinogen concentrate, 1 mg | Status Indicator change (from N to K) |
| Q0181 | 1/1/2014 | N | Unspecified oral dosage form, FDA approved prescription anti-emetic, for use as | Status Indicator change (from E to N) |
| Q4143 | 4/1/2014 | N | Repriza, Per Square Centimeter | Assignment of Low/High Cost Status as Low |
| Q4147 | 4/1/2014 | N | Architect Extracellular Matrix, Per Square Centimeter | Assignment of Low/High Cost Status as High |
| Q4148 | 4/1/2014 | N | Neox 1k, Per Square Centimeter | Assignment of Low/High Cost Status asHigh |
| Q2052 | 4/1/2014 | N | Services, supplies and accessories used in the home under the Medicare intravenous immune globulin (ivig) demonstration | New HCPCS code |
For more information, please refer to the April 2014 OPPS update at MLN Matters Article MM8653.
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..
This material was compiled to share information. MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.
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