Two Fluorouracil Codes, $740 Apart
CMS posted the October preliminary Part B payment limit file Tuesday afternoon. It deletes ten J codes, adds thirty-eight, reprices 799 of the 879 that carry over, and splits three ancient generics into a generic code and a manufacturer-specific one priced up to 380 times higher. Zoledronic acid is up 425.83%. Two antivenoms start paying again and a cyanide antidote stops.
If you bill fluorouracil, one of your J codes stops existing on October 1.
CMS posted the October preliminary Part B payment limit file Tuesday at 14:32 GMT, about three weeks before it starts paying. It deletes ten HCPCS codes, adds 38, and reprices 799 of the 879 codes that carry over from July.
The deletions cost you money on the first pass. The replacements are where it gets expensive.
"When one deleted code comes back as two, which one are you supposed to bill?"
The rest of this brief is for subscribers.
The impact tables, the code-level detail, and the rest of the analysis sit past this line.
$50 a month, or $500 a year.
Already a subscriber? Sign in