ACloserLook Reimbursement Issues in Diagnostic Imaging

April 2008 Update of Hospital Outpatient Prospective Payment System (HOPPS)

CMS has issued Transmittal 1487 that contains numerous updates to HOPPS. It is effective April 1, 2008.

Among the updates is an item regarding Correct Reporting of Units for Drugs. Providers are reminded to ensure that the units of drugs administered to patients are accurately reported per the dosage specified in the full HCPCS code descriptor. For 2008, CMS implemented edits that will reject a claim for most nuclear medicine procedures if the claim lacks a code for a radiopharmaceutical.

CMS has Revised Long and Short HCPCS Code Descriptors for Echocardiography Services. To ensure appropriate reporting of the services, CMS has revised the short and long descriptors for C8921 through C8928 to reflect those services that either use contrast or are performed without contrast followed by contrast use. In addition, hospitals are reminded to bill for echocardiograms without contrast in accordance with the CPT code descriptors and guidelines associated with the applicable Level I CPT code(s) 93303-93350.

For more information on the April 2008 HOPPS Update, please visit: http://www.cms.hhs.gov/transmittals

Spring 2008 Newsletter


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