2021 Part A MAC Update

2021 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2021. 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 1/1/2021 unless otherwise noted below.
 

Major Category III. A. -Chemotherapy

J9144

DARATUMUMAB, HYALURONIDASE

J9223

INJ. LURBINECTEDIN, 0.1 MG

J9227

INJ. ISATUXIMAB-IRFC 10 MG

J9281

MITOMYCIN INSTILLATION

J9304

INJ. PEMETREXED, 10 MG

J9316

PERTUZU, TRASTUZU, 10 MG

J9317

SACITUZUMAB GOVITECAN-HZIY

DESCRIPTOR CHANGE ONLY-EFFECTIVE JAN 1, 2021

J9305

ING. PEMETREXED NOS 10MG