The Integrated Outpatient Code Editor Summary of Data Changes document, published quarterly by CMS, is exceedingly valuable for hospital chargemaster maintenance. It is concise and lists all coding changes by their effective date. It is an essential for quarterly chargemaster updates.

The IOCE Summary of Data Changes document provides all quarterly changes related to:

APC CHANGES

  • Added APCs
  • APC Description Changes

HCPCS/CPT PROCEDURE CODE CHANGES

  • Added HCPCS/CPT Procedure Codes
  • HCPCS Changes- APC, Status Indicator and/or Edit
  • Edit Assignments
  • Procedure/ Device Pair Changes

MODIFIERS

  • Added Modifiers

REVENUE CODES

  • Added Revenue Codes

To demonstrate how concisely changes are published in the Summary of Data Changes, I've listed the following changes for the April 1, 2010, IOCE v 11.1.

 

Five New APCs
APC APC Description Status Indicator
09258 Telavancin injection G
09259 Pralatrexate injection G
09260 Ofatumumab injection G
09261 Ustekinumab injection G
09262 Fludarabine phosphate, oral G
09263 Ecallantide injection G

 

Two APC Descripton Changes
APC Old Description New Description
00902 Injection, onabotulinumtoxinA Injection, onabotulinumtoxinA
01289 AbobotulinumtoxintypeA AbobotulinumtoxinA

 

Six New HCPCS Level II Codes
HCPCS Code Description SI APC Edit
C9258 Telavancin injection G 09258 55
C9259 Pralatrexate injection G 09259 55
C9260 Ofatumumab injection G 09260 55
C9261 Ustekinumab injection G 09261 55
C9262 Fludarabine phosphate, oral G 09262 55
C9263 Ecallantide injection G 09263 55

 

Eleven APC and/or SI and/or Edit Changes
HCPCS Code Description Old SI New SI Old Edit New Edit
80101 Drug screen, single A E N/A 28
99241 Office consulation     9 28
99242 Office consultation     9 28
99243 Office consultation     9 28
99244 Office consultation     9 28
99245 Office consultation     9 28
99251 Inpatient consultation     9 28
99252 Inpatient consultation     9 28
99253 Inpatient consultation     9 28
99254 Inpatient consultation     9 28
99255 Inpatient consultation     9 28

 

One New Modifier
Modifier Effective Date
GX 04/01/2010

 

Two New Revenue Codes
Revenue Code Status Indicator
0860 N
0861 N

The centralization of quarterly changes to these codes and modifiers in one document has provided a single-source publication that can be used to assure accuracy and reduce the time and effort devoted to quarterly chargemaster updates.

You can access the Integrated Outpatient Code Editor Summary of Data Changes in the Coding Suite.                                                                                                                                       

Written by Vicky Fry, MS, MBA

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