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2018 Part A MAC Update

Guidance for SNF consolidated billing file reflects new codes that have been developed for 2018.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 05, 2020

2018 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2018. In addition, the file reflects additions to categories of services excluded from consolidated billing.

The annual update file below contains the complete list of HCPCS codes that are excluded from SNF CB for claims submitted to Part A MACs for payment.   Minor Surgery and Part B therapy inclusions are also included with this file.  This file is effective for claims with dates of service on or after 1/1/2018 unless otherwise noted below.

Major Category I. B. - Cardiac Catheterization

ADD – C9741 (eff. 1/1/16)

Major Category II. A. - (Dialysis) Coding Applicable to EPO and Aranesp Services

ADD – J0604 and J0606

Major Category III. A. - Chemotherapy

ADD – J9022, J9023, J9203, J9285

REMOVE – J9300

Major Category III. C. - Radioisotopes and their Administration

ADD – Eff. 1/1/2016 for all codes as follows: A9606, 77770, 77771 and 77772

REMOVE – Eff. 12/31/15 for all codes as follows: 77785, 77786 and 77787

 

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.