AHA Coding Clinic® for HCPCS - 2009 Issue 2; FOR your INFORMATION
Reporting Multiple HCPCS Codes for Drug
Historically, CMS has provided instructions to report only the lowest available administrative dose of a drug if multiple HCPCS codes existed for the drug. As of January 1, 2008, the outpatient prospective payment system (OPPS) has recognized each HCPCS code, regardless of the units identified in the drug descriptor. According to information provided by CMS, hospitals now have the option to report multiple HCPCS codes for a single drug administered, or continue to bill the HCPCS code with the lowest dosage descriptor available. This information can be found in CY 2008 OPPS/ASC Final Rule, 72 FR 66775-66776 dated November...
Subscribe or sign in to view the full article.
Article Overview
This brief article summarizes a CMS update for hospital outpatient billing under OPPS and notes the shift described in the 2008 final rule and related CMS transmittal guidance. It is relevant to coders, billing staff, and compliance teams who need to understand the policy context for reporting drug-related HCPCS codes in the outpatient setting.
Why This Topic Matters
The article highlights a CMS policy change that affects outpatient drug billing practices and references the official sources supporting that update. Readers can use it to understand the historical context and locate the CMS materials tied to the change.
What You Will Learn
- The CMS policy context for reporting drug-related HCPCS codes in outpatient billing.
- Which CMS rulemaking and update documents are referenced as the basis for the guidance.
- How the article frames the change in reporting options at a high level.
- The outpatient setting and payment system discussed in the article.
Who Should Read This
- Hospital outpatient coders
- Billing staff
- Revenue cycle professionals
- Compliance personnel
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com