AHA Coding Clinic® for HCPCS - 2003 Quarter 4; FOR your INFORMATION
Updated billing instruction for the placement of drug-eluting stents
Effective for services furnished on or after July 1, 2003, CMS is implementing payment under APC 0656, Transcatheter placement of drug eluting coronary stents, for two temporary HCPCS codes that describe drug-eluting stents and their placement. Hospitals may include the charge for the drug-eluting stent in the charge for HCPCS codes G0290 and code G0291 . Hospitals may, however, bill separately for the stent using an appropriate revenue code, making certain that the charge for the HCPCS procedure code does not include the charge for the stent. Payment will be made under APC 0656 for the placement of the stents...
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Article Overview
This article covers CMS billing guidance for hospital outpatient placement of drug-eluting coronary stents and the transition to updated payment handling effective July 1, 2003. It is relevant to hospital billing staff, coders, and revenue cycle professionals who need to understand which APCs, HCPCS procedure codes, and earlier outpatient procedure codes are referenced in the guidance. The article discusses how the billing framework changed over time and the general options described for reporting the stent and procedure charges.
Why This Topic Matters
The guidance affects how hospital outpatient claims for drug-eluting stent placement are categorized and paid during the specified time period. Understanding the article helps billing teams recognize the relevant CMS update and the identifiers involved when reviewing historical outpatient claims.
What You Will Learn
- The CMS update and its effective date
- The outpatient billing context for drug-eluting coronary stents
- The APCs and procedure identifiers referenced in the guidance
- The distinction between the updated and prior billing framework
Who Should Read This
- Hospital coders
- Outpatient billing staff
- Revenue cycle professionals
- Compliance teams
Codes Discussed
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