Health Information Management

Q/A: Has CMS established any new procedure codes for the April OPPS update?

APCs Insider, March 22, 2013

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Q: Has CMS established any new procedure codes for the April OPPS update?

A: In Transmittal R2264CP, the April update to OPPS, CMS established two new HCPCS procedure codes:
 
  • C9734, focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, withor without magnetic resonance (MR) guidance
  •  
  • C9735, anoscopy; with directed submucosal injection(s), any substance
C9734 is assigned status indicator S (significant procedure, not discounted when multiple) and to APC 0067. C9735 is assigned status indicator T (significant procedure, multiple reduction applies) and to APC 0150.
 
CMS provides guidance in the transmittal concerning C9735. This HCPCS code describes the injection procedure for Solesta and is reportable only with HCPCS code L8605 (injectable bulking agent dextranomer/hyaluronic acid copolymer implant, anal canal, 1ml, includes shipping and necessary supplies).
 
Be sure that the chargemaster line item representing L8605 includes the cost for the shipping and any supplies related to the agent as noted in the code description.
 
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.



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