Health Information Management

Tip: CMS makes changes to device edits in 2015

APCs Insider, January 9, 2015

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CMS will no longer implement specific procedure-to-device or device-to-procedure edits for any APCs in 2015. Instead, the agency created claims processing edits that require any device codes used in previous device-to-procedure edits to be included on claims that include procedure codes assigned to device-dependent APCs.
 
Providers must report any medical device C code listed among the device codes, rather than a specific device C code, to meet the requirement for reporting a device for device-dependent procedure APCs.
CMS implemented additional changes to ensure only the correct claims receive edits for these services.
 
Additionally, CMS will no longer be using the term "device-dependent APC." Instead, APCs with a device offset of more than 40% will be referred to as "device-intensive APCs" and subject to no cost/full credit and partial credit device policies.
 
This tip is adapted from “CMS updates physician certification requirements for inpatient services” in the December issue of Briefings on APCs.



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