AHA Coding Clinic® for HCPCS - 2002 Issue 2; For your information
Hospital outpatient prospective payment system update
Earlier this year, two program memoranda (PM), were issued by the Centers for Medicare and Medicaid Services (CMS) Transmittal A-01-145 and Transmittal A-01-150 informing hospitals of a delay in the implementation of the 2002 Outpatient Prospective Payment System (OPPS) updates. Facilities were instructed not to submit claims for OPPS services utilizing any of the new 2002 HCPCS codes during the delay. Per the instructions during the delay only HCPCS 2001 codes and modifiers were allowed for the billing of OPPS services. Now as a result of the delay CMS has issued Program Memorandum, Transmittal A-02-026 outlining special billing requirements...
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Article Overview
This article summarizes a CMS update for hospital outpatient prospective payment system billing during the period before April 1, 2002. It is relevant to hospital outpatient coders, billing staff, and compliance teams who need to understand the temporary use of prior-year HCPCS coding resources, the handling of new 2002 codes and modifiers, and the timing of implementation for outpatient claims under OPPS.
Why This Topic Matters
It helps readers identify the time-limited billing framework that applied to hospital outpatient claims during the OPPS transition period and understand which CMS communications controlled the delay and later implementation. The article is useful for evaluating whether claims from early 2002 were subject to special processing requirements.
What You Will Learn
- The CMS communications referenced in the outpatient payment system update
- The time period affected by the temporary billing requirements
- How the article frames claim submission and processing during the transition
- Which broad HCPCS coding resources were in scope for hospital outpatient billing during the affected period
- How implementation timing changed for hospitals under OPPS
Who Should Read This
- Hospital outpatient coders
- Hospital billing staff
- Revenue cycle professionals
- Compliance personnel
- Medicare payment administrators
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