CMS adds laboratory drug testing codes, revises IMRT and SRS guidance

May 24th, 2016

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews CMS’s April 2016 I/OCE update for outpatient hospital claims. It focuses on newly added laboratory drug testing HCPCS codes, status indicator corrections and pass-through updates for several drug products, and revised billing guidance affecting IMRT planning and SRS-related services. The article is intended for coding, billing, and revenue cycle professionals who need to understand how the update affects claim processing and reporting.

Why This Topic Matters

These changes can affect whether claims process correctly, how services are packaged or separately paid, and how providers report related outpatient services under CMS guidance.

Article Sections

  1. Laboratory testing codes added

    Discusses the addition of new laboratory drug testing HCPCS codes in the April I/OCE update and the related claim-processing context for outpatient billing.

  2. Status indicator and pass-through updates

    Summarizes CMS status indicator changes for selected drug products and notes the addition of new pass-through drugs in the update.

  3. Updated guidance

    Covers CMS’s revised billing guidance for IMRT planning and updated clarification for modifier use with stereotactic radiosurgery-related services.

What You Will Learn

  • How CMS’s April 2016 I/OCE update affects outpatient claim processing
  • Which general categories of HCPCS drug testing and drug-payment updates were included
  • What areas of billing guidance were revised for IMRT planning and SRS-related services
  • How CMS updates can affect packaged versus separately processed outpatient services

Who Should Read This

  • Medical coders
  • Outpatient hospital billers
  • Revenue cycle staff
  • Compliance professionals
  • Practice managers

Codes Discussed

  • HCPCS: G0477
  • HCPCS: G0478
  • HCPCS: G0479
  • HCPCS: G0480
  • HCPCS: G0481
  • HCPCS: G0482
  • HCPCS: G0483
  • CPT: 90653
  • HCPCS: J2704
  • HCPCS: J1443
  • HCPCS: J0130
  • HCPCS: J0583
  • CPT: 77014
  • CPT: 77280
  • CPT: 77285
  • CPT: 77290
  • CPT: 77295
  • CPT: 77301
  • CPT: 77305
  • CPT: 77321
  • CPT: 77331
  • CPT: 77370
  • CPT: 77371
  • CPT: 77372

Code Ranges Discussed

  • CPT: 77305 through 77321

Modifiers Discussed

  • Unspecified: -CP

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