Health Information Management

Q/A: Additional the drugs and biological with pass through status

APCs Insider, June 22, 2012

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Q:  Did CMS approve any new items for pass through status for July?

A:  Yes, CMS granted pass-through status to two drugs and biologicals as of July 1:
  • C9368, Grafix core, per square centimeter
  • C9369 , Grafix prime, per square centimeter
 
Grafix is a cellular matrix designed for application directly to acute and chronic wounds.  Because providers use these matrixes to treat wounds, watch for updates to your FI/MACs Local Coverage Determinations  that will specify coverage and reporting requirements, including reporting of the amount of product wasted.
 
These are new HCPCS codes for July as well, so if your facility uses these items, update your chargemaster with line items that reflect the cost/charge of the item.  Make sure the units are reported “per square centimeter” and providers document the amount of product wasted in the medical record.
 
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.



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