Ambulatory Surgical Center Payment System July 2019 Update

Surgical Center CodingAn Ambulatory Surgical Center Payment System (ASC PS) update that took effect July 1, 2019, changes billing instructions for various payment policies and codes. Here is what you need to know to properly bill Medicare for these services and supplies.

New CPT Category III Codes

Effective July 1, 2019, the Centers for Medicare & Medicaid Services (CMS) is implementing the following five CPT® Category III codes in the Ambulatory Surgical Center Payment System:

CPT
Code
Long Descriptor ASC PI
0548T Transperineal periurethral balloon continence device; bilateral placements,
including cystoscopy and fluroscopy
J8
0549T Transperineal periurethral balloon continence device; unilateral placements,
including cystoscopy and fluroscopy
J8
0550T Transperineal periurethral balloon continence device; removal,
each balloon
G2
0551T Transperineal periurethral balloon continence device; adjustment of balloon(s) fluid volume R2
0558T Computed tomography scan taken for the purpose of biomechanical computed tomography analysis Z2

Updated payment rates that took effect July 1, 2019, are in the July 2019 update of Ambulatory Surgical Center Payment System Addendum BB.

Newly Established HCPCS Level II Codes for Separately Payable Drugs and Biologicals

Ten new separately payable drug and biological HCPCS Level II codes took effect July 1 and are listed below. Eight of the products are new. J7208 replaces HCPCS Level II code C9141. Another HCPCS Level II code, J9030, replaces HCPCS Level II code J9031.

 

New
HCPCS
Code
Old
HCPCS
Code
Long Descriptor ASC PI
J9036 Injection, bendamustine hydrochloride, Belrapzo/ bendamustine, 1mg K2
J7208 J9141 Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1, i, u K2
J9356 Injection, trastuzumab, 10 mg and Hyaluronidase-oysk K2
J9030 J9031 BCG live intravesical instillation, 1mg K2
J9047 Injection, caplacizumab-yhdp, 1 mg K2
J9048 Dexamethasone, lacrimal ophthalmic insert, 0.1mg K2
J9049 Injection, tagraxofusp-erzs, 10 mcg K2
J9050 Injection, emapalumab-lzsg, 1 mg K2
J9051 Injection, omadacycline, 1 mg K2
J9052 Injection, ravulizumab-cwvz, 10 mg K2
Descriptor Change for the HCPCS Level II Code J9355

Effective July 1, 2019, the short and long descriptors for the HCPCS Level II code J9355 are updated. Refer to the table below for the new and old descriptors.

 

HCPCS
Code
Old
Short Descriptor
New
Short Descriptor
Old
Long Descriptor
New
Long Descriptor
J9355 Trastuzumab injection Inj trastuzumab excl biosimi Injection, trastuzumab, 10 mg Injection, trastuzumab, excludes bioslimilar 10 mg
Payment Indicator Revision for Flu Vaccine CPT Code 90689

CMS is revising the status indicator from “E1” to “L1” Influenza vaccine; pneumococcal vaccine. Packaged item/service; no separate payment made for CPT code 90689 retroactive to Jan. 1, 2019.

CPT
Code
Short Descriptor Long  Descriptor ASC PI
90689 Vacc iivv4 no prsrv 0.25 ml im Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use L1

For complete details, see the official instruction, CR11328.

For More Information: https://www.aapc.com/blog/47888-ambulatory-surgical-center-payment-system-july-2019-update/

Add Comment

3700 Wilshire blvd, suite 979
Los Angeles, California 90010