CMS Announces Significant Code Changes for Outpatient Surgery Centers

Medicare contractors have received updated instructions and specifications for the Jan. 2012 Integrated Outpatient Code Editor, according to an AAPC report.

The contractors will use version 13.0 to edit claims paid under OPPS and non-OPPS for hospital outpatient departments, community mental health centers and for all non-OPPS providers, as well as for limited services when provided in a home health agency not included under the Home Health Prospective Payment System.

The update includes several ambulatory payment classifications and HCPCS Level II and CPT code changes, most of which go into effect Jan. 1, 2012.

There are 28 new APCs, 25 deleted APCs, 26 APCs with description changes and 15 ACPs with status indicator changes, according to the report. New APCs include 00331 Combined abdomen and pelvis CT without contrast, as well as 09366 EpiFix wound cover. Deleted APCs span from 00245 Level I cataract procedures without IOL insert to 09364 Porcine implant, Permacol.

Description changes to APCs are intended to make codes more specific, and some significantly change the code meaning. For example, 00040's description has changed from Percutaneous implantation of neurostimulator electrodes to Level I implantation/revision/replacement of neurostimulator electrodes.

For a complete list of HCPCS Level II and CPT procedure codes added or deleted effective Jan. 1, 2012, please read CMS' Transmittal 2370.

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