Health Information Management

Tip: Five categories packaged in 2014 OPPS

APCs Insider, January 31, 2014

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As part of the 2014 OPPS Final Rule, CMS dramatically increased packaged services and made clear that the trend will continue in 2015 and beyond.
In the final rule, CMS packaged five categories:
  • Drugs, biologicals, and radiopharmaceuticals that function as supplies when used in a diagnostic test or procedure
  • Drugs and biologicals that function as supplies or devices when used in a surgical procedure
  • Clinical diagnostic laboratory tests (except molecular pathology) when provided on the same date of service as another service
  • Procedures described by add-on codes
  • Device removal procedures 
CMS had proposed packaging the following categories as well, but did not finalize any changes, so they will continue to be separately payable under OPPS in 2014:
  • Ancillary services (currently assigned status indicator X); proposal to reassign all services to status indicator Q1
  • Diagnostic tests on the bypass list
 
This tip is adapted from “CMS dramatically increases packaging in 2014 OPPS Final Rule” in the February issue of Briefings on APCs.



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