CMS Releases July Update to Hospital OPPS

Two transmittals issued by the Centers for Medicare and Medicaid Services provided updates to the Hospital Outpatient Prospective Payment System, including clarification of outpatient diagnostic services policies and changes to device and Category III codes to be implemented on July 1, 2010.

The changes in outpatient diagnostic and therapeutic services, outlined in Transmittal 128, clarify when physician assistants, nurse practitioners and other non-physician providers can provide services and when they are not considered supervisory physicians for certain tests or services.

Transmittal 1976 addresses changes in device and Category III codes. Device edits must include the proper HCPCS codes as well as a device code in order to be processed. Further information is available on the OPPS website.

The new Category III codes effective July 1 are:

• HCPCS 0223T — Acoustic cardiography, including automated analysis of combined acoustic and electrical intervals; single, with interpretation and report
• HCPCS 0224T — Multiple, including serial trended analysis and limited reprogramming of device parameter - AV or VV delays only, with interpretation and report
• HCPCS 0225T — Multiple, including serial trended analysis and limited reprogramming of device parameter - AV and VV delays, with interpretation and report
• HCPCS 0226T — Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); diagnostic, including collection of specimen(s) by brushing or washing when performed
• HCPCS 0227T — Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); with biopsy(ies)
• HCPCS 0228T — Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, cervical or thoracic; single level
• HCPCS 0229T — Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, cervical or thoracic; each additional level (List separately in addition to code for primary procedure)
• HCPCS 0230T — Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; single level
• HCPCS 0231T — Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with ultrasound guidance, lumbar or sacral; each additional level (List separately in addition to code for primary procedure)
• HCPCS 0232T — Injection(s), platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed
• HCPCS 0233T — Skin advanced glycation endproducts (AGE) measurement by multi-wavelength fluorescent spectroscopy

Read CMS Transmittal 128 (pdf).

Read CMS Transmittal 1976 (pdf).

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