In its final rule for outpatient procedures, CMS rejected a request to develop specific payment codes for some orthopedic implants, saying providers could assign charges to a C-code or an uncoded revenue line.
A comment on the previous proposed rules noted a large number of implantable devices are reported using HCPCS code C1713 "anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)." The comment said CMS should evaluate the adequacy of the device codes to allow for accurate tracking and cost estimation.
In response, CMS stated, "We do not believe that this limits hospitals’ ability to report accurate costs." The agency said hospitals could assign device charges to a C-code or an uncoded revenue line.
The final rules also stated that payment adjustment policy for no cost/full credit and partial credit devices will apply to certain ambulatory payment classifications listed in the final rule. The rule also lists final payment adjustment percentages for no cost/full credit and partial credit.
In addition, the final rule added one new APC for Implantation of Cranial Neurostimulator Pulse Generator and Electrode and deleted a proposed APC Implantation of Neurostimulator Electrodes, Cranial Nerve.
Read page 76 of the final CMS rule.
Read more on orthopedic coding:
- 10 ASC Coding Challenges and Guidelines That May Impact Your ASC's Bottom Line
- ASC Coding Guidance: Interbody Cage(s)
- 2010 Medicare Payments for 12 Spine Procedures
A comment on the previous proposed rules noted a large number of implantable devices are reported using HCPCS code C1713 "anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)." The comment said CMS should evaluate the adequacy of the device codes to allow for accurate tracking and cost estimation.
In response, CMS stated, "We do not believe that this limits hospitals’ ability to report accurate costs." The agency said hospitals could assign device charges to a C-code or an uncoded revenue line.
The final rules also stated that payment adjustment policy for no cost/full credit and partial credit devices will apply to certain ambulatory payment classifications listed in the final rule. The rule also lists final payment adjustment percentages for no cost/full credit and partial credit.
In addition, the final rule added one new APC for Implantation of Cranial Neurostimulator Pulse Generator and Electrode and deleted a proposed APC Implantation of Neurostimulator Electrodes, Cranial Nerve.
Read page 76 of the final CMS rule.
Read more on orthopedic coding:
- 10 ASC Coding Challenges and Guidelines That May Impact Your ASC's Bottom Line
- ASC Coding Guidance: Interbody Cage(s)
- 2010 Medicare Payments for 12 Spine Procedures