AHA Coding Clinic® for HCPCS - 2001 Issue 1

Device specific C-codes replaced by category codes

Two codes are required to qualify for a transitional passthrough payment for devices—a CPT-4 code for the procedure performed and a C-code for the device inserted. C-codes are a special series of codes within HCPCS used only for pass-through items under OPPS (devices, drugs or biologicals). C-codes may not be used to bill services paid under other Medicare payment systems or other payors. C-codes were specific to a particular brand, trade name, or a specific model number. The Benefits Improvement and Preservation Act (BIPA) of 2000 required the use of categories for the payment of devices, rather than...

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