CMS has added nine newly created HCPCS codes that will be added to the ASC list of covered ancillary services effective July 1.
The nine drugs and biologicals separately payable under the ASC payment system that have been granted ASC payment status effective July 1, along with their long and short descriptors and payment indicators, are as follows:
|
HCPCS Code |
Long Descriptor |
Short Descriptor |
ASC PI |
|
C9283 |
Injection, acetaminophen, 10 mg |
Injection, acetaminophen |
K2 |
|
C9284 |
Injection, ipilimumab, 1 mg |
Injection, ipilimumab |
K2 |
|
C9285 |
Lidocaine 70 mg/tetracaine 70 mg, per patch |
Patch, lidocaine/tetracaine |
K2 |
|
C9365 |
Oasis Ultra Tri-Layer Matrix, per square centimeter |
Oasis Ultra Tri-Layer Matrix |
K2 |
|
C9406 |
Iodine I-123 ioflupane, diagnostic, per study dose, up to 5 millicuries |
Dx I-123 ioflupane, per dose |
K2 |
|
Q2041* |
Injection, von willebrand factor complex (human), Wilate, 1 i.u. vwf:rco |
Wilate injection |
K2 |
|
Q2042 |
Injection, hydroxyprogesterone caproate, 1 mg |
Hydroxyprogesterone caproate |
K2 |
|
Q2043* |
Sipuleucel-t, minimum of 50 million autologous cd54+ cells activated with pap-gm-csf, including leukapheresis and all other preparatory procedures, per infusion |
Sipuleucel-T auto CD54+ |
K2 |
|
Q2044 |
Injection, belimumab, 10 mg |
Belimumab injection |
K2 |
The HCPCS codes identified with an asterisk are replacement codes. HCPCS code Q2041 is replacing HCPCS code J7184 beginning on July 1. The payment status of J7184 beginning July 1 will change from K2 (drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate) to Y5 (non-surgical procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made). HCPCS code Q2043 is replacing HCPCS code C9273 beginning on July 1. C9273 will be deleted for dates of service July 1 and forward. The July 2011 ASCPI file will reflect the changes PI=Y5 for J7184 and PI=D5 for C9273 effective July 1.
Source: CMS
Related Articles on ASC Coding and Billing:
CMS Adds Six New HCPCS Codes to ASC List of Covered Surgical Procedures
How to Determine When to Go In-Network vs. Out-of-Network
Preparing Your Surgery Center for ICD-10: Part 3