Health Information Management

Q/A: Replacement for HCPCS code Q1003

APCs Insider, April 22, 2011

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Q: We learned that HCPCS Q1003(new technology, intraocular lens, category 3 [reduced spherical aberration]) was deleted as of April 1 under the OPPS. Can you recommend a replacement code?

A: Based on our research, HCPCS code C1780 (lens, intraocular [new technology]) became effective April 1, 2001, and the most recent information about this code was published in the Federal Register May 3, 2000 (p.25740).

The code was designed to report new technology intraocular lenses under OPPS and originally qualified for pass-through payment until December 31, 2002.

The new technology lenses were further defined by more specific Q codes. Q1003 was the only Q code approved for reporting on the UB04 form and had a status indicator N (packaged, no separate payment) under OPPS.

Medicare considers the following lenses new technology and reportable with HCPCS Q1003; however, note that Q1003 has been deleted as of April 1.
Medicare’s outpatient list of intraocular lenses that qualify for HCPCS Q1003 includes:

• Bausch & Lomb: Akreos® AO
• Bausch & Lomb: Akreos® MI60
• Hoya: FY-60AD
• Hoya: FC-60AD
• Alcon: Acrysof® IQ Toric Model SN6ATT
• Tecnis® models Z9000, Z9001, Z9002 and ZA9003, also AR40xEM and ZCB00 manufactured by Advanced Medical Optics
• AcrySof® IQ SN60WF and Acrysert™ SN60WS by Alcon
• Sofport® models LI61AO and LI61AOV by Bausch & Lomb
• Affinity™ Collamer® CQ2015A, CC4204A and Elastimide™ AQ2015A by STAAR

We recommend reporting C1780 (lens, intraocular (new technology) beginning April 1, for the above-referenced intraocular lenses because they still represent new technology. We recommend reporting HCPCS code V2632 (posterior chamber intraocular lens) or V2630 (anterior chamber intraocular lens) for lenses that don’t meet CMS’ definition of new technology.

Editor’s note: Denise Williams, RN, CPC-H, director of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.

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