Health Information Management

Q/A: New device pass-through categories

APCs Insider, February 3, 2012

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Q: Will CMS ever approve any new device pass-through categories?

A: CMS established one new device pass-through category for CY 2012, HCPCS code C1886 (catheter, extravascular tissue ablation, any modality [insertable]).

Under OPPS payment methodology, a pass-through payment for a device includes an offset of the APC payment. When a pass-through code is reported and reimbursed, CMS deducts amount for the procedure the APC payment because payment for devices without pass-through has been included in the calculation of the APC payment.

Finance and billing departments should monitor these payment amounts to ensure appropriate application of this methodology.

Editor’s note: Andrea Clark, RHIA, CCS, CPCH, chairman, CEO, and founder of Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.



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