2016 Part A MAC Update

2016 First Quarterly Update:

The following codes are added to the 2016 annual update file:

Major Category I. B. - Cardiac Catheterization

ADD – Eff. 1/1/2016 for all codes as follows: 93600, 93602, 93603, 93609, 93610, 93612, 93613, 93615, 93616, 93618-93624, 93631, 93640 - 93642, 93644, 93650, 93653, 93654, 93655, 93656, 93657, 93660, 93662

Note: Claims for dates of service on or after 1/1/2016 that have previously rejected due to a SNF CB edit for the above code may be adjusted to correct payment.

2016 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2016. In addition, the file reflects additions to categories of services excluded from consolidated billing.

The annual update file below contains the complete list of HCPCS codes that are excluded from SNF CB for claims submitted to Part A MACs for payment.   Minor Surgery and Part B therapy inclusions are also included with this file.  This file is effective for claims with dates of service on or after 1/1/2016 unless otherwise noted below.

Major Category I. I. – Additional Surgery HCPCS – EXCLUSIONS

ADD - eff. 1/1/2014 - C9600-C9608, 92928, 92929, 92933, 92934, 92937, 92938, 92941, 92943 and 92944

REMOVE - G0290, G0291, G0297

Major Category III. A. –Chemotherapy

ADD - J9032, J9039, J9267 - eff. 1/1/2015, J9271, J9299 and J9308

REMOVE - J9265 - eff. 1/1/2015 and J9010

Major Category V. A. - Therapies - INCLUSION

ADD – eff. 1/1/2015 - 97607 and 97608