Outpatient PPS Update


December 26, 2001
For information contact 1-800-424-4301

The Centers for Medicare & Medicaid Services' (CMS) recent decision to delay implementation of the 2002 outpatient prospective payment system (OPPS) rates raises a potentially sticky coding glitch: new codes are not likely to be recognized by CMS' current payment systems. In the program memoranda we faxed you last week, CMS said that hospitals should not submit a claim containing any new 2002 HCPCS codes for outpatient services. Rather, they should submit the claim with the 2001 code, if available.

Of the approximately 400 new codes for 2002, we believe the attached list of 144 are most likely to be affected by the delay in implementing OPPS. This shortened list excludes those codes and services paid through some other method (like, for example, a fee schedule) or otherwise excluded (like inpatient only procedures). The AHA will keep you informed of developments through our special OPPS updates. These advisories will be posted at www.aha.org. For more information, call the AHA's member services line at 800-424-4301.



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