Health Information Management

Q&A: Why are we receiving errors for skin substitute HCPCS codes?

APCs Insider, April 19, 2013

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Q: We have a wound care center that applies skin substitutes. We have started receiving error messages regarding HCPCS codes C9367 and Q4129. We have validated the correct reporting of these codes based on the documentation, so why are we receiving error messages?

A: These changes are the result of the April 1 update to the integrated outpatient code editor (I/OCE). In Transmittal 2667, CMS notes that the skin substitute list has been updated. CMS deleted two codes:
 
  •  C9367, skin substitute endoform dermal template, per square centimeter (retroactive to January 1, 2013)
  •   Q4129, Unite biomatrix per square centimete)
 
C9367 was deleted as of December 31, 2012, but was not removed from the I/OCE. CMS had issued guidance to contractors to manually delete the code from the system, but is now applying the change via the software.
 
Q4129 has been removed from the skin substitute list. According to information available about this product, it is a collagen wound dressing and not a skin substitute.
 
CMS added code Q4127 (Talymed per square centimeter) effective April 1, 2013.
 
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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