January 2010 Code Set Updates: HCPCS, APC, Phys Fee

The 2010 HCPCS Level II update is now available in CCH Coding Comply. The updated data files became available on CMS’ website late Monday Night. It is anticipated that this update will be released in the HCPCS and CPT electronic code book in the Coding Suite and RRS sometime next week. When complete, a link will be provided in the “Hot Topics” box on the Welcome page of the Coding Suite.

We have identified over 145 new codes, 40 modified codes, and more than 60 deleted codes. Within the new codes you will find G0425 – G0427, which now cover inpatient telehealth consultations with the patient. The modified codes include E0441 – E0444; and C9251 – C9253 have been deleted for January 1, 2010. To view these changes in CCH Coding Comply, users can simply click on the HCPCS Level II update in the Recent Updates area of the tool for the next seven days or they can search the HCPCS code set via the “Search Code Sets” tab for any additions, modifications, and deletions with a 1/1/2010 start date.

In addition to the January update for HCPCS, users will also find the updated January 1, 2010, data for the Physician Fee Schedule code set. This data was released over the weekend and is too available in the Recent Updates area of CCH Coding Comply, or by searching the Physician Fee Schedule code set for additions, modifications, and deletions with a 1/1/2010 start date.

Available on Thursday morning of this week will be the January 1, 2010 update for the APC code set. It is important for us to note, however, that the data for this update will not include any changes for HCPCS “J” codes. Per our communication directly with CMS earlier this week, the data that was released in the FY 2010 OPPS Final Rule on Friday does not have the January ASP drug pricing data factored into the payment rates for those codes impacted by ASP data. The same situation occurred last year and after much analysis of last year’s files and the Final rule files, we found that the range of codes most impacted by ASP data is the “J” drug code range. Accordingly, we have decided to update the APC data in CCH Coding Comply with everything but the “J” code information so that knowingly incorrect data is not released to customers; yet they will be able to utilize the rest of the code set for forecasting and annual planning. We will bring you the updated “J” code data in January 2010 after CMS releases that data in a new Addendum B file. Beginning Thursday you will find the changes to the APC code set in the Recent Updates section, or by searching for additions, modifications, and deletions with a 1/1/2010 start date. Because this data does not include the January ASP drug pricing data, the Coding Suite and RRS will not be updated with the APC Addendas until January when all-inclusive versions of these files will be made available by CMS. The rationale behind the update in Comply and the Coding Suite will be made known to our customers via stories written for the MediBlog, What’s New newsletter, and the Coding Compliance Advisor newsletter.

With the addition of these three updates to CCH Coding Comply, the only full update we have left for January 2010 is the Clinical Lab code set. Communications from CMS have indicated this data will be available after November 18, 2009. Stay tuned to the weekly What’s New newsletter for information related to this update.