HCPro, JustCoding Outpatient - 2017 Issue 41 (October)
Healthcare News: October quarterly OPPS update introduces new laboratory testing codes, biological product modifier
October 10th, 2017
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Article Overview
This article reviews an October 2017 outpatient prospective payment system update that adds new laboratory-related CPT/PLA codes and a new HCPCS modifier associated with a biosimilar biological product. It is relevant for coding, billing, and reimbursement professionals who need to track effective dates, code set changes, and CMS implementation timing for outpatient claims.
Why This Topic Matters
Quarterly OPPS updates can affect how laboratory tests and biosimilar-related services are reported and processed for outpatient claims. This article helps readers stay current on newly introduced identifiers, their general coverage area, and the timing considerations tied to CMS implementation.
What You Will Learn
- What the October 2017 OPPS quarterly update covered at a high level
- Which broad categories of laboratory testing were added in the update
- How the update addressed a biosimilar biological product modifier
- Why effective dates and CMS implementation timing matter for outpatient reporting
Who Should Read This
- Medical coders
- Outpatient hospital billing staff
- Revenue cycle professionals
- Compliance teams
- Payers and claims-processing staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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