AHA Coding Clinic® for HCPCS - 2004 Quarter 3; FOR your INFORMATION
Billing update for drug eluting stents
In July 2003, the Centers for Medicare & Medicaid Services (CMS) added two HCPCS codes G0290 and G0291 for the placement drug eluting stents. Given that C codes were reinstituted by CMS on January 1, 2004, recent instructions published in Publication 100-04, Transmittal 195, state that hospitals are now able to report charges for drug eluting stents with HCPCS code C1874 , Stent coated/covered, with delivery system, and the appropriate revenue code. CMS further instructs hospitals to make certain that the charges for HCPCS codes G0290 and G0291 for placement of the stents does not include the stent charge when...
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Article Overview
This premium article explains a CMS billing update for hospitals that report drug eluting stent-related services. It covers the relevant CMS publication and transmittal context, the transition in HCPCS reporting, and the general charge-separation considerations involved. It is useful for hospital coders, billing staff, and reimbursement teams tracking CMS updates and device-related billing policy.
Why This Topic Matters
Hospitals need current guidance to align charge reporting with CMS instructions and avoid inconsistent billing for device-related services. The article helps readers understand how a CMS update affects reporting workflows and charge structure for drug eluting stent cases.
What You Will Learn
- What CMS updated for hospital billing of drug eluting stent-related services
- How the article frames the reporting change in relation to CMS publications
- What broad charge capture considerations are discussed for hospitals
- Which HCPCS reporting elements are involved in the update
Who Should Read This
- Hospital coders
- Hospital billing staff
- Revenue cycle teams
- Compliance staff
- Reimbursement analysts
Codes Discussed
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