AHA Coding Clinic® for HCPCS - 2009 Quarter 1; FOR your INFORMATION
Reporting biologicals used as implantable devices
When reporting biologicals where the HCPCS code describes a product that is solely surgically implanted or inserted, hospitals are to report the appropriate HCPCS code for the product whether the HCPCS code is identified as having pass-through status or not. However, when using biologicals as implantable devices during surgical procedures (including as a scaffold or an alternative to human or nonhuman connective tissue or mesh used in a graft) where the HCPCS code describes a product that may be either surgically implanted or inserted or otherwise applied in the care of a patient, hospitals should not separately report the...
Subscribe or sign in to view the full article.
Article Overview
This article covers how hospitals should report biological products when they are used as implantable devices in outpatient surgical settings. It focuses on OPPS payment packaging, the distinction between products that are solely implanted versus those that may also be applied in other ways, and the role of pass-through status. It is relevant to hospital coders, outpatient facility billing staff, and reimbursement professionals who need to understand how biological implant-related reporting is addressed in hospital claims.
Why This Topic Matters
Correct handling of implantable biologicals affects hospital claim reporting and outpatient payment packaging. The guidance helps facilities align reporting practices with OPPS treatment of supportive items and avoid inconsistent handling of biological products used in surgical procedures.
What You Will Learn
- How hospital reporting is addressed for biological products used as implantable devices
- How OPPS packaging applies to supportive items in surgical procedures
- How pass-through status is relevant to reporting considerations for biological products
- How the article distinguishes products based on their intended use as implanted or otherwise applied items
Who Should Read This
- Hospital coders
- Outpatient facility billing staff
- Reimbursement specialists
- Revenue integrity staff
- Compliance teams
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com