Health Information Management

Q&A: CMS changes HCPCS description

APCs Insider, October 10, 2014

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Q: Now that October has arrived, has CMS made any corrections to the information effective October 1 under the OPPS?
A:  CMS did publish a correction effective October 1 that could be significant for hospital providers. Transmittal 3080 includes this change: the long description for HCPCS code C9135 has been changed to “per i.u.” rather than “per 10 i.u.,” as originally published.
The correct description is now “Factor IX (antihemophilic factor, recombinant), Alprolix, per i.u.” 
Facility providers should ensure that pharmacy systems and the chargemaster are updated to reflect this change. Otherwise, the units for this item will be under-reported and reimbursement will be affected, as C9135 is assigned to status indicator G (pass-through drugs and biologicals).
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular