Health Information Management

Pay-per-view: CMS proposes to expand ancillary services packaging policies

APCs Insider, September 25, 2015

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CMS proposes to continue expanding its policies for packaging ancillary services one year after eliminating status indicator X (ancillary services) and reassigning those services to Q1 (conditionally packaged) and S (significant procedure, not discounted when multiple).
 
For 2016, CMS proposes packaging Level 4 minor procedures by assigning the CPT® codes associated with this APC to status indicator Q1.
 
It also proposes to package Level 3 and 4 pathology service HCPCS codes when they are billed with a surgical service by assigning the codes associated with these two levels of pathology services to status indicator Q2.
 
CMS believes these services to be typically ancillary or adjunctive to another primary service, most commonly surgery. By assigning status Q2 to the CPT codes assigned to Level 3 and 4 pathology services, CMS will allow separate payment if these procedures are provided on a different date of service from the surgical service.
 
CMS continues to exempt certain preventive services from the ancillary packaging policy.
 
Continue reading "CMS proposes 2% reduction in 2016 conversion factor due to laboratory overestimation" on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the September issue.



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