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Updates to the ASC Payment Center & Billing Instructions for July 1

Attention Ambulatory Surgical Centers:

CMS released changes to the ASC payment center and billing instructions for various payment policies that will be implemented on July 1, 2017. Make sure your billing staff is aware of these changes before the update is released.

Effective July 1, 2017:

  • NEW Category lll CPT Code
    • 0474T – Insj aqueous drg dev io rsvr – July 2017 ASC PI: J8
  • New Separately Payable HCPCS Codes 
    • C9745 – Nasal endo Eustachian tube – July 2017 ASC PI: J8
    • C9746 – Trans imp balloon cont – July 2017 ASC PI: J8
    • C9747 – Ablation, HIFU, prostate – July 2017 ASC PI: G2
  • Two New HCPCS codes with OPPS Pass-Through Status for reporting drugs and bilogicals
    • C9489 – Injection, nusinersen – ASC PI: K2
    • C9490 – Injection, bezlotoxumab – ASC PI: K2
  • Updated Payment Rates and Drug Price Restatements
  • Retroactive payment rate corrections for some drugs and biological
  • New Drug HCPCS Codes
    • Q9986 – Inj, Makena – ASC PI: K2
  • ASC Payment Indicator Change for influenza vaccine CPT Code 90682
    • For January 1, 2017 – June 30, 2017 : the ASC PI code is Y5
    • Effective July 1, 2017: the ASC PI code is L1
  • Revised Status Indicator for HCPCS code J1725
    • The ASC PI will change to Y5 (previously K2) effective July 1, 2017
  • Other Changes for CY 2017 HCPCS Codes
      HCPCS Code C9487 will be replaced with HCPCS Codes Q9989 effective July 1, 2017

Click here for more details and view the full article from CMS regarding ASC updates for July 1, 2017: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10138.pdf