AHA Coding Clinic® for HCPCS - 2005 Issue 3

CMS mandates device code reporting

Effective for services provided on or after April 1, 2005, any hospital paid under the Outpatient Prospective Payment System (OPPS) must report a device code when reporting a code for insertion of a device. Edits have been installed into the outpatient code editor (OCE) for services on or after April 1, 2005, that will not allow claims to be processed for payment if the device code is not reported by OPPS hospitals. However, special conditions apply for hospitals that insert surgical devices that do not incur any costs for the devices. Some scenarios include, but are not limited to:...

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