Health Information Management

No more grace period for HCPCS

APCs Insider, August 5, 2004

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

QUESTION: I heard that Medicare has eliminated the 90-day grace period for Healthcare Common Procedure Coding Systems (HCPCS) code reporting as of January 1, 2005. Is this true?

ANSWER: Yes, Medicare has eliminated the 90-day grace period for HCPCS code reporting for physicians, hospitals, and suppliers who use HCPCS in billing Medicare carriers, Durable Medical Equipment Regional Carriers (DMERCs), and fiscal intermediaries (FIs).

Effective January 1, 2005, carriers, DMERCs, and FIs will no longer accept discontinued HCPCS codes for dates of service January 1 through March 31 of the current year (beginning in 2005) that are submitted prior to April 1. HCPCS codes must be valid at the time service is rendered or your claims may be returned and not paid. All claims with discontinued CPT or HCPCS Level II codes will be returned to the provider for correction. Transmittal 89 provides these instructions and can be found at www.cms.hhs.gov

Historically, CPT code books published by the American Medical Association are released in the beginning of October, so securing your book order is crucial. Annual updates to HCPCS codes can be downloaded from CMS's Web site at www.cms.hhs.gov in October. The HCPCS quarterly updates are also available from this Web site. It is imperative that hospitals structure a plan for encoder, chargemaster, and technology updates as well as facility education.



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