Health Information Management

Q&A: Did CMS update pass-through devices in July’s quarterly update?

APCs Insider, June 19, 2015

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Q: Are there any new pass-through devices or changes for July under the OPPS?
 
A: CMS has published one new pass-through device category and one change to an existing pass-through device. HCPCS code C2613 (lung biopsy plug with delivery system) is new, beginning July 1. This code is assigned to status indicator H (additional payment for pass-through device categories, brachytherapy sources, and radiopharmaceutical agents) and APC 2613. Section 1833 (t)(6)(D)(ii) of the Social Security Act required that CMS apply a device offset amount when pass-through payment is applicable. This will be applied to APC 0005 as C2613 should always be billed with CPT® code 32405 (biopsy, lung or mediastinum, percutaneous needle).
 
In April 2015, CMS noted that it would apply a device offset when C2623 (catheter, transluminal
angioplasty, drug-coated, nonlaser) was reported—the affected APCs were 0083, 0229, and 0319. CMS reviewed this information and determined that the costs associated with C2623 are not reflected in these APCs and the offset is not applicable. This change is retroactive to April 1.   
 
For more information, seeTransmittal 3280.
 
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Fort Lauderdale, Florida, answered this question.



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