AHA Coding Clinic® for HCPCS - 2006 Issue 4
Device-related code edits
For calendar year (CY) 2004, the Centers for Medicare & Medicaid Services (CMS) reactivated the use of device C-codes. In CY 2005, reporting of device codes was made mandatory where an appropriate code existed to identify a device used. Also in CY 2005, HCPCS code edits were implemented to ensure that charges for devices used in device-dependent APC procedures were completely reported. The device code edits were implemented in two phases. The first set of device edits were implemented on April 1, 2005 and the remaining set on October 1, 2005. However, since many services and procedures performed do...
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Article Overview
This premium article covers CMS guidance on outpatient device-related code edits, including the background for the edits, the implementation timeline, and how the edit concept applies to device reporting on hospital claims. It is relevant to hospital outpatient coders, APC/OCE users, and compliance staff who need to understand which general device categories and procedure relationships are discussed in the 2007 edit changes. The article also includes a non-exhaustive example involving device reporting on the same claim as a procedure code, along with CMS contact and posting information.
Why This Topic Matters
Accurate device reporting affects outpatient claim processing and compliance with CMS edit logic. Understanding the scope of the edits helps billing teams recognize when device and procedure reporting relationships are discussed for hospital outpatient claims.
What You Will Learn
- The background and timeline for CMS outpatient device-related code edits.
- How the article frames device-to-procedure edit relationships in hospital outpatient claims.
- Which general device categories are included in the 2007 edit list.
- How CMS describes claim-level reporting interactions between devices and procedures.
- Where CMS directs comments and where the edits are posted.
Who Should Read This
- Hospital outpatient coders
- APC/OCE users
- Revenue cycle staff
- Compliance teams
- Billing managers
Codes Discussed
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