Health Information Management

Tip: CMS proposes expanding packaging in 2015

APCs Insider, September 12, 2014

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CMS has included several proposals in the 2015 OPPS proposed rule that would expand packaging, a common theme for the OPPS in recent years.
 
With device-dependent add-on codes to be paid through Comprehensive APCs, CMS has proposed to package the add-on codes assigned to device-dependent APCs starting in 2015. These codes are listed in Table 9 of the proposed rule.
 
CMS proposes to package and change the status indicator from A (services furnished to a hospital outpatient paid under a fee schedule or payment system other than OPPS) to N (items and services packaged into APC rates) for all durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
 
CMS says this is consistent with changes finalized in 2014 for all non-prosthetic DMEPOS supplies (with the status indicator changed from A to N). If this proposed change is finalized for 2015, then all medical and surgical supplies would be packaged in OPPS.
 
This tip is adapted from “CMS reintroduces Comprehensive APCs along with complexity adjustments” in the September issue of Briefings on APCs.



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