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Tip of the Week: Differentiate between STVX packaged and T-packaged services

APCs Weekly Monitor, January 25, 2008

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It's important to understand that there are two types of services that have a status indicator of Q:

• STVX packaged services
• T-packaged services

STVX packaged services refer to three specific HCPCS codes: 75898, 76000, and 0126T. If a coder reports a CPT or HCPCS code with a status indicator of Q on the same date of service as one of these three STVX codes, CMS will not generate a separate APC payment. But if the coder reports a status indicator Q service by itself or with other CPT/HCPCS code(s) without a status indicator of STVX, then CMS will generate payment.

Status indicator Q services are T-packaged services. There are 93 T-packaged services codes that CMS processes using a similar logic to the one it uses to process STVX packaged services. If a coder reports a line item with a status indicator Q on the same date of service as a T-packaged code, the Outpatient Code Editor will not generate a separate APC payment for the service with the status indicator Q. If the coder reports a status indicator Q line item on a date of service without a status T procedure, then it will generate separate reimbursement.

This is how services with status indicator Q are fundamentally different from those that are newly designated as unconditionally packaged with status indicator N. Status indicator Q services may generate separate payment under certain circumstances, whereas status indicator N services never will.

(The above tip was excerpted from the January issue of Briefings on APCs).

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