January 2010 ASC Payment System Update

New HCPCS Level II codes have been created for reporting specific drugs and biologicals in 2010. Twenty-three of the new codes are separately payable to ambulatory surgical centers (ASCs) for service dates on or after Jan. 1, 2010. In addition, 2009 payment rates for six HCPCS Level II codes have been corrected.

New HCPCS Level II codes for drugs and biologicals separately payable under the ASC payment system for 2010 are as follows:

Updated Payment Rates for Certain HCPCS Level II Codes

You should also be aware that the payment rates for three HCPCS Level II codes were incorrect in the April 2009 ASC DRUG file. The following corrected payment rates are in the revised April 2009 ASC DRUG file effective for services furnished on April 1 through implementation of the July 2009 update.

Likewise, the payment rates for three HCPCS Level II codes were incorrect in the July 2009 ASC DRUG file. The following corrected payment rates have been included in the revised July 2009 ASC DRUG file effective for services furnished on July 1 through implementation of the October 2009 update.

Suppliers who think they may have received an incorrect payment between April 1 and Sep. 30 may request contractor adjustment of the previously processed claims.

Information regarding ASC billing for procedures involving no cost/full credit and partial credit devices is available in the Centers for Medicare & Medicaid Services (CMS) Transmittal 1865, Change Request (CR) 6746, and in the Medicare Claims Processing Manual, Pub 100-04, chapter 14, section 40.8.

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