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CMS Internal HCPCS Coding Decisions

Guidance for critical data related to the logistics, time and resources involved in adding a public component to CMS’ internal code request process.

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

Issue Date: July 08, 2016

The Centers for Medicare & Medicaid Services is conducting a limited demonstration for a web-based notice and comment mechanism allowing public input on requests to discontinue Level II HCPCS codes that are generated internally based on national program operating needs; not the subject of other notice and comment mechanisms; are not replaced by other or new codes.

This demonstration provides a valuable opportunity for CMS to gather critical data related to the logistics, time and resources involved in adding a public component to CMS’ internal code request process, so that we can find an appropriate balance between the need for transparency and stakeholder input, and the need to be nimble in making coding changes to improve program administration, to the extent practicable.

CMS reserves the right to make immediate changes without notice (and take comments afterwards), when we have a national program operating need to do so.

CMS’ 2016 Internal requests to discontinue permanent level II HCPCS codes (that are not the subject of other notice and comment mechanisms and/or that are not replaced by other or new codes) can be found at New Internal Coding Decisions Published 07/05/2016 (PDF).

Public comments are due, in writing, via hcpcs@cms.hhs.gov by the date specified in the individual announcement. Note that CMS may publish more than one such announcement on different dates.

CMS’ HCPCS Workgroup will re-review the internal requests, together with input received timely via the above process. The final decision will be folded into the outgoing HCPCS Annual Update.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

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.