AHA Coding Clinic® for HCPCS - 2016 Quarter 3
Do HCPCS device codes really matter?
The question continues to resurface regarding the reporting of HCPCS device codes and whether the reporting of device codes really matters. In response to that question, the answer is yes. Hospitals are still required to use HCPCS device codes when billing for devices used in the outpatient setting. These codes are required to identify devices used in conjunction with procedures paid under the outpatient prospective payment system (OPPS). What is a transitional pass-through? Although we don’t normally address payment issues, we feel that it is important for you to understand the significance of reporting the device codes. Pass-through...
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Article Overview
This article covers why HCPCS device codes are still relevant in hospital outpatient billing under Medicare OPPS. It discusses transitional pass-through payments, device kits, and implantable devices, along with general guidance on how device category codes relate to outpatient claims and Medicare references.
Why This Topic Matters
The topic matters for hospital billing and coding teams that need to understand whether device reporting is still required and how it affects outpatient claims processed under OPPS. It also helps readers recognize the kinds of device-related situations addressed by Medicare guidance.
Article Sections
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What is a transitional pass-through?
Introduces Medicare pass-through payment concepts and their relationship to outpatient payment policy. It also addresses how device reporting is tied to hospital claims under OPPS.
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Clarification of device kits
Discusses how packaged device kits are treated in the context of outpatient device reporting. It distinguishes between kit contents that may be reportable and other associated supplies.
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Implantable devices
Covers the general treatment of implants and related biological materials in hospital outpatient coding. It also notes broad considerations for reporting device category codes for certain surgical procedures.
What You Will Learn
- How Medicare OPPS relates to hospital reporting of device-related services
- What transitional pass-through payments are in broad terms
- How packaged device kits are discussed in outpatient device coding guidance
- How implantable devices are addressed in general coding guidance
- What kinds of Medicare references are used for device category code reporting
Who Should Read This
- Hospital outpatient coders
- Inpatient/outpatient billing staff
- Revenue cycle professionals
- Coding compliance staff
- Health information management professionals
Codes Discussed
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