Revenue Cycle

CMS releases October OPPS update

Recovery Auditor Report, September 6, 2012

CMS released the October OPPS update this week with a smattering of unrelated, but important updates. There were also two corrections to the claim manual in this update.

One of the manual corrections appears to be aimed at removing a barrier to payment for bariatric surgery in hospital outpatient departments. Although CPT code 43770 (laparoscopic placement of adjustable gastric band), was removed from the inpatient only list effective January 1 of this year, there remained a notation in the claims processing manual that the procedure was only payable on a type of bill 11X, an inpatient type of bill.   CMS corrected this to indicate that the procedure is also payable on 13X, outpatient hospital, and 85X, critical access hospital outpatient, types of bills.  

Continue reading Kimberly’s note at the Medicare Mentor Blog.

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