Effective April 1, 2022, hospitals will have nine new procedure codes to describe the introduction or infusion of therapeutics, including the additional COVID-19 vaccines recently authorized for emergency use by the Food and Drug Administration.
April Update
The Centers for Medicare & Medicaid Services first introduced seven new ICD-10-PCS codes for the second quarter of 2022. The procedure codes are:
XW013V7 Introduction of COVID-19 vaccine dose 3 into the subcutaneous tissue, percutaneous approach, new technology group 7
XW013W7 Introduction of COVID-19 vaccine booster into subcutaneous tissue, percutaneous approach, new technology group 7
XW023V7 Introduction of COVID-19 vaccine dose 3 into muscle, percutaneous approach, new technology group 7
XW023W7 Introduction of COVID-19 vaccine booster into muscle, percutaneous approach, new technology group 7
XW0DXR7 Introduction of fostamatinib into mouth and pharynx, external approach, new technology group 7
XW0G7R7 Introduction of fostamatinib into upper GI, via natural or artificial opening, new technology group 7
XW0H7R7 Introduction of fostamatinib into lower GI, via natural or artificial opening, new technology group 7
On Jan. 12, 2022, CMS added two new procedure codes:
XW023X7 Introduction of tixagevimab and cilgavimab monoclonal antibody into muscle, percutaneous approach, new technology group 7
XW023Y7 Introduction of other new technology monoclonal antibody into muscle, percutaneous approach, new technology group 7
These procedures are designated as non-operating room procedures, so there is no assigned Major Diagnosis Category (MDC) or Medicare Severity-Diagnosis Related Group (MS-DRG).
The updated code tables, index, and related addenda files for these new procedure codes are available on the CMS website.
COVID-19 Vaccine Billing Note
Make sure to use the appropriate CPT® codes for COVID-19 vaccines administered by injection to hospitalized patients to ensure proper reimbursement for the administration. Hospitals should not seek reimbursement for the COVID-19 vaccine product if it was supplied for free, and patients should not be billed for the COVID-19 vaccine at this time.
For More Information: https://www.aapc.com/blog/83878-2021-e-m-guidelines-faq-february/