Health Information Management

Pay-per-view: Skin substitutes packaged in 2014 OPPS Final Rule

APCs Insider, February 21, 2014

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Skin substitutes have historically been paid as biologicals in OPPS under the average sales price (ASP) methodology subject to the drug packaging threshold.
CMS has determined that they should be packaged for 2014, since they are biologicals that function as supplies or devices when used in a surgical procedure.
CMS says that skin substitutes must be used when performing surgical procedures in the 15271–15278 CPT code range.
They effectively function as necessary supplies for the repair procedures, which is why CMS determined these were appropriate to package for 2014, says Jugna Shah, MPH, president and founder of Nimitt Consulting.
Continue reading CMS dramatically increases packaging in 2014 OPPS Final Rule on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the February issue.

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