Health Information Management

Q&A: Did CMS change its packaging of skin substitutes in the latest OPPS update?

APCs Insider, April 18, 2014

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Q: Did CMS issue any new HCPCS codes for drugs and biologicals for April 2014?
A: CMS added one new HCPCS code for a monoclonal antibody effective April 1. HCPCS code C9021 (Injection, obinutuzumab, 10) is assigned status indicator G (pass-through drugs and biologicals; separate APC payment).  This was not detailed in Transmittal 2903 but was noted in the Business Requirements Table and in Transmittal 2900, the April 2014 update to the I/OCE.
In addition, Transmittal 2900 notes that the status indicator for HCPCS code Q4121 (Theraskin)  has changed from N (packaged) to G ) effective April 1, 2014. If this skin substitute is used, the APC payment will be subject to the device offset as separate payment will be made for the line item.
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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