CMS issues certain quarterly updates relating to hospital outpatient services.These updates are primarily issued in the form of two recurring update notification transmittals (RUN).The first of these is a quarterly update to the IOCE Specifications. The second is a quarterly update to the Outpatient Prospective Payment System (OPPS). Because the most significant outpatient hospital changes become effective as of the beginning of each calendar year, the January updates are particularly important.Click the link above for more information and an in-depth analysis.
CMS added modifier -AO (provider declined alt payment method) and new HCPCS codes to the I/OCE as part of the October 2013 quarterly update found in Transmittal 2763.
The 2014 OPPS proposed rule is shorter than normal at 718 pages, but the proposed changes are significant and probably the most sweeping changes since the inception of OPPS, says Jugna Shah, MPH, president and founder of Nimitt Consulting.
Eight CPT® codes for multianalyte assays with algorithmic analyses (MAAA) procedures are now classified as not covered under OPPS (status indicator E), retroactive to January 1, 2013. These codes are now subject to I/OCE edit 9.
The Hospital Outpatient Payment Panel recommended CMS change the supervision requirements for 15 HCPCS and CPT codes during its second meeting this year in August. CMS released details of the meeting September 24.
