Revised Payment Indicators and Effective Dates for HCPCS Codes 90620, 90621, and Q5101
o Effective January 23, 2015, the payment indicators for HCPCS codes 90620 (Menb pr w/omv vaccine im) will change from ASC PI=Y5 (Non-Surgical
Procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made) to ASC PI=K2 (Drugs and biologicals paid
separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate).
o Effective October 29, 2014, the payment indicator for HCPCS code 90621 (Menb rlp vaccine im) will change from ASC PI=Y5 (Non-Surgical Procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made.) to ASC PI=K2 (Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate).
o Effective September 3, 2015, the payment indicator for HCPCS code Q5101 (Injection, Filgrastim (G-CSF), Biosimilar, 1 microgram) will change from ASC PI Y5 (Non-Surgical Procedure/item not valid for Medicare purposes because of coverage, regulation and/or statute; no payment made.) to ASC PI=K2 (Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate).
Suppliers who think they may have received an incorrect payment impacted by this change may request their MAC to adjust previously processed claims.
Ambulatory surgical center billing code guidelines and how to get payment from insurance. ASC denial, CPT CODES , Authorization and referral Guide. Multiple procedure, Surgical procedure tips. What to get the correct reimbursement in ASC billing setup. SNF billing Guide, tips to use correct CPT AND POS.
Saturday, October 17, 2015
Medicare payment guideline update for cpt code 90620, 90621 and Q5101
Labels:
ASC billing basic,
CPT codes,
Medicare
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