Health Information Management

Tip: Note latest APCs added to I/OCE

APCs Insider, October 17, 2014

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CMS added these four APCs in the latest I/OCE update, effective October 1:
  • 1487, injection, testosterone undecanoate, 1 mg, assigned to HCPCS C9023
  • 1488, injection, ramucirumab, 5 mg, assigned to HCPCS C9025
  • 1489, injection, vedolizumab, 1 mg, assigned to HCPCS C9026
  • 1486, factor IX (antihemophilic factor, recombinant), Alprolix, per i.u., assigned to HCPCS C9135
CMS will change the status indicators for two HCPCS codes from K (paid under OPPS; separate APC payment) to E (not paid by Medicare when submitted on outpatient claims [any outpatient bill type]), effective October 1:
  • J9160, injection, denileukin diftitox, 300 micrograms
  • J9300, injection, gemtuzumab ozogamicin, 5 mg
The APCs for denileukin diftitox (01084) and gemtuzumab ozogamicin (9004) have been deleted.
This tip is adapted from “MACs to reprocess radiosurgery claims due to copayment miscalculation” in the October issue of Briefings on APCs.

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