July 2010 OPPS Update

on Tuesday, 22 June 2010. All News Items

On June 4, 2010, CMS released a corrected transmittal regarding the July 2010 Update of OPPS.  The transmittal included the following lists of new HCPCS codes:

Category III CPT Codes Implemented as of July 1, 2010

HCPCS                  Long Descriptor                                                                                                SI                   APC
0223T                  Acoustic cardiography, including automated analysis of combined       S                   0099
                              acoustic and electrical intervals; single, with interpretation and 
                              report
0224T                  Multiple, including serial trended analysis and limited                               S                  0690
                             reprogramming of device parameter – AV or VV delays only, with
                             interpretation and report
0225T                 Multiple, including serial trended analysis and limited                                S                  0690
                             reprogramming of device parameter – AV and VV delays, with
                             interpretation and report
0226T                 Anoscopy, high resolution (HRA) (with magnification and                           X                  0340
                            chemical agent enhancement); diagnostic, including collection of
                            specimen(s) by brushing or washing when performed
0227T                Anoscopy, high resolution (HRA) (with magnification and                            T                   0146
                           chemical agent enhancement); with biopsy(ies)
0228T                Injection(s), anesthetic agent and /or steroid, transforaminal                      T                   0207
                            epidural, with ultrasound guidance, cervical or thoracic; single
                            level
0229T                Injection(s), anesthetic agent and /or steroid, transforaminal                       T                 0206
                           epidural, with ultrasound guidance, cervical or thoracic; each
                           additional level (List separately in addition to code for primary
                           procedure)
0230T               Injection(s), anesthetic agent and /or steroid, transforaminal                       T                 0207
                          epidural, with ultrasound guidance, lumbar or sacral; single level
0231T              Injection(s), anesthetic agent and /or steroid, transforaminal                         T                0206
                          epidural, with ultrasound guidance, lumbar or sacral; each
                          additional level (List separately in addition to code for primary
                           procedure)
0232T              Injection(s), platelet rich plasma, any tissue, including image                       X               0340
                         guidance, harvesting and preparation when performed
0233T              Skin advanced glycation endproducts (AGE) measurement by                      A                NA
                          multi-wavelength fluorescent spectroscopy


Drugs and Biologicals with OPPS Pass-Through Status Effective July 1, 2010

HCPCS         Long Descriptor                                              APC                                      Status Indicator Effective 7/1/10
C9264          Injection, tocilizumab, 1 mg                           9264                                                           G
C9265          Injection, romidepsin, 1 mg                           9265                                                           G
C9266          Injection, collagenase clostridium               9266                                                           G
                      histolyticum, 0.1 mg
C9267          Injection, von Willebrand factor complex     9267                                                          G
                      (human), Wilate, per 100 IU VWF: RCO
C9268          Capsaicin, patch, 10cm2                               9268                                                          G
C9367          Skin substitute, Endoform Dermal              9367                                                           G
                      Template, per square cm
(All the above ‘C’ codes are new codes effective July 1, 2010)

New HCPCS Codes Effective for Certain Drugs and Biologicals Effective July 1, 2010

HCPCS          Long Descriptor                                           APC                                        Status Indicator Effective 7/1/10
Q2025           Fludarabine phosphate, oral, 1 mg          9262                                                              G

Also, the transmittal indicated that effective April 1, 2010, HCPCS code 90670 (Pneumococcal conjugate vaccine, 13 valent, for IM use) will be separately paid and the price will be updated on a quarterly basis.  The SI for this code is changing from ‘E’ to ‘K’.

To read the complete July OPPS update, including information on allogeneic stem cell transplant procedures, see CMS Transmittal 1980 (CR 6996) or view the MLN Matters Article MM6996

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