The annual update of the Healthcare Common Procedure Coding System (HCPCS) directly affects skilled nursing facilities (SNFs) this quarter. The Centers for Medicare & Medicaid Services (CMS) is adding HCPCS Level II code J9033 Injection, bendamustine hcl, 1 mg to the list of codes used for SNF consolidated billing enforcement, effective Jan. 1, 2012.
Contractors are instructed to reopen or reprocess claims for J9033 with dates of service on or after Jan. 1, 2012 that have been previously denied prior to the upcoming Oct. 1 implementation date.
Bendamustine hydrochloride (trade name Treanda) is an alkylating agent recently approved by the Food and Drug Administration (FDA) for treatment of chronic lymphocytic leukemia (CLL).
Source: CMS Transmittal 2484, Change Request (CR) 7856, issued June 8
June 18th, 2012
The annual updated version of the National Correct Coding Initiative (NCCI) policy manual for Medicare services will be effective Jan. 1, 2012, rather than Oct. 1, 2011. This manual will be posted on the NCCI website on or around Dec. 1, 2011.
CMS posts changes to each of its NCCI and Medically Unlikely Edit (MUE) edit files on a quarterly basis. Download a test file of Version 18.0, effective Jan. 1, 2012, from the National Correct Coding Initiative Edits Quarterly NCCI and MEU Version Update Changes page on the Centers for Medicare & Medicaid Services (CMS) website. The final file will be available “on or about” Nov. 17, according to CMS Transmittal 2322.
Visit the National Correct Coding Initiative Edits Overview page on the CMS website for more information about NCCI.
October 28th, 2011
The Centers for Medicare & Medicaid Services (CMS) recently announced a number of changes to HCPCS Level II codes effective at the end of the second quarter (July 1). Changes include new codes for oxygen, wound care, headaches, and other new initiatives.
(more…)
April 15th, 2011
The April 2010 update of HCPCS Level II codes is now available on the Centers for Medicare & Medicaid Services (CMS) website. Downloadable files include one for a smattering of C codes and another involving four modifiers.
New C codes effective April 1 are:
| HCPCS Code |
Long Description |
| C9258 |
Injection, telavancin, 10 mg |
| C9259 |
Injection, pralatrexate, 1 mg |
| C9260 |
Injection, ofatumumab, 10 mg |
| C9261 |
Injection, ustekinumab, 1 mg |
| C9262 |
Fludarabine phosphate, oral, 1 mg |
| C9263 |
Injection, ecallantide, 1 mg |
Modifiers revised or added, effective April 1 are:
| HCPCS Code |
Long Description |
Action |
Coverage |
|
|
|
|
| GA |
Waiver of liability statement issued, as required by payer policy |
Revise |
C |
|
|
|
|
| GX |
Notice of liability issued, voluntary under payer policy |
ADD |
C |
| |
|
|
|
| RA |
Replacement of a dme, orthotic or prosthetic item |
Revise |
|
| |
|
|
|
| RB |
Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair |
Revise |
|
Download these files from the HCPCS Quarterly Update webpage on the CMS website.
Refer to the April 2010 update of the hospital Outpatient Prospective Payment System (OPPS) for further information on these codes.
April 5th, 2010