|
January 2007 Procedure/Device Code Edits
Happy New Year!
As we are still implementing the changes to the 2007 Final Outpatient
Prospective Payment System (OPPS), the Outpatient Code Editor, Version 8.0 was
also updated.
As part of the Outpatient Claim Editor (OCE), edit 71 (claim lacks required
device or procedure code) was also updated to include 5 new procedure codes for
which devices are required to be reported with the procedure codes. The
additional CPT codes/description, device code/descriptions are listed below:
| 36566 |
Insert tunneled cv cath |
requires |
C1881 Dialysis access |
| 65770 |
Revise cornea w/implant |
requires |
C1818 Int keratoprosthesis system |
| 65770 |
Revise cornea w/implant |
requires |
L8609 Artificial cornea |
| 19296 |
Place po breast cath for rad |
requires |
C1728 Cath, brachytx seed |
| 19297 |
Place breast cath for rad |
requires |
C1728 brachytx seed |
View the entire list of January 2007 procedure/device code edits
Any claim that reports a HCPCS code for a procedure listed on the table of
device edits that does not also report at least 1 device HCPCS code required
for that procedure will be returned to the provider. The hospital will need to
modify the claim by either correcting the procedure code or ensuring that one
of the required device codes is on the claim before resubmission. Device edits
do not apply if modifier -52, -73, or -74 is reported with the procedure code.
This is an opportunity to review the charge description masters (CDM) for the
appropriate departments to ensure the devices are in the CDM. In addition the
practice for ensuring that the device has been entered into the billing system
when a device-required procedure has been done should also be reviewed.
Wishing you a Happy and prosperous 2007!
|
