In
April 2001, CMS established the process of periodically updating the lists of
Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the
consolidated billing provision of the Home Health Prospective Payment System (HH
PPS). Services appearing on this
list of submitted claims, to Medicare
Fiscal Intermediaries and Carriers including Durable Medical Equipment Regional
Carriers (DMERCs), will not be paid on dates when a beneficiary for whom such a
service is being billed is in a home health episode. Medicare will only directly reimburse the primary home health
agencies that have opened such episodes during the episode period.
Note that items incidental to physician services, as well as supplies
used in institutional settings are not subject to HH consolidated billing.
On
July 2002, CMS established that updates of the HH consolidated billing code list
would occur as frequently as quarterly in order to reflect the creation of
temporary HCPCS codes. These
temporary codes may describe services subject to consolidated billing in
addition to the permanent list of HCPCS codes that is updated annually.
This publication provides the first quarterly
HH consolidated billing update for calendar year 2003.
It incorporates new temporary codes, as well as the annual update of all
HCPCS codes and CPT codes that are subject to consolidated billing.
Therefore, this PM is referred to as an annual update.
Other updates for the remaining quarters of the calendar year will occur
as needed due to the creation of new temporary codes representing services
subject to HH consolidated billing prior to the next annual update.
The
new coding identified in each update describes the same services that were used
to determine the applicable HH PPS payment rates.
No additional services will be added by these updates; that is, new
updates are required by changes to the coding system, not because the services
subject to HH consolidated billing are being redefined.
Crosswalk of Changes to Home Health Consolidated Billing Coding
January 2003 Update
Note new codes replace deleted codes when both appear on the same line.
Comprehensive List of HCPCS Codes Subject to Home Health Consolidated Billing
January 2003 Update
Therapy Codes
 |
 |
|
Comprehensive List of HCPCS Codes Subject to Home Health Consolidated Billing January 2003 Update Supply Codes |
|
 |
 |
 |
 |
 |
CR2402/Trans AB-02-137/10-11-02/LV