Health Information Management

Q&A: CMS changes HCPCS description

APCs Insider, October 10, 2014

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Q: Now that October has arrived, has CMS made any corrections to the information effective October 1 under the OPPS?
 
A:  CMS did publish a correction effective October 1 that could be significant for hospital providers. Transmittal 3080 includes this change: the long description for HCPCS code C9135 has been changed to “per i.u.” rather than “per 10 i.u.,” as originally published.
 
The correct description is now “Factor IX (antihemophilic factor, recombinant), Alprolix, per i.u.” 
 
Facility providers should ensure that pharmacy systems and the chargemaster are updated to reflect this change. Otherwise, the units for this item will be under-reported and reimbursement will be affected, as C9135 is assigned to status indicator G (pass-through drugs and biologicals).
 
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.



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