January 2015 update of the ambulatory surgical center payment system

Summary

The Centers for Medicare & Medicaid Services (CMS) recently updated billing instructions for various payment policies implemented in the January 2015 ambulatory surgical center (ASC) payment system.
In the release, CMS updates 2015 payment rates for separately payable drugs and biologicals, including descriptors for newly created Level II Healthcare Common Procedure Coding System (HCPCS) entries, and covered surgical and ancillary services. Other key updates include:

• A new HCPCS device pass-through category as of January 1, 2015, for the outpatient prospective payment system (OPPS) and the ASC payment systems. That HCPCS code is C2624 (Wireless pressure sensor).

• A new HCPCS surgical procedure code effective January 1, 2015, (C9742 Laryngoscopy with injection).

• Coding guidance for “drop-less cataract surgery."

• A list of skin substitute products and their assignment as either a high-cost or a low-cost skin substitute product.

Provider Action Needed
Change Request (CR) 9021 informs MACs about changes to and billing instructions for various payment policies implemented in the January 2015 ASC payment system update. As appropriate, this notification also includes updates to the Healthcare Common Procedure Coding System (HCPCS).

Included in this notification are Calendar Year (CY) 2015 payment rates for separately payable drugs and biologicals, including descriptors for newly created Level II HCPCS codes for drugs and biologicals (ASC DRUG files), and covered surgical and ancillary services (ASCFS file).