Health Information Management

Pay-per-view: CMS adds to skin substitute product lists

APCs Insider, October 10, 2014

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For any new skin substitute products approved for payment during 2014, CMS will use a $32 per square centimeter threshold to determine mapping to the high- or low-cost skin substitute group. Any new skin substitute products without pricing information are assigned to the low-cost category until pricing information becomes available.
In the October update, CMS added one product to the high-cost group, effective July 1:
  • Q4137, Amnioexcel® or Biodexcel®, per square centimeter 
CMS also added two products to the high-cost skin substitute group, effective October 1:
  • Q4138, BioDfence DryFlex®, per square centimeter
  • Q4140, BioDfence®, per square centimeter 
These three products have all been assigned status indicator N (items and services packaged into APC rates).
Continue reading MACs to reprocess radiosurgery claims due to copayment miscalculation on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the October issue.

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