This document is from:

CMS Manual System

Pub. 100-04 Medicare Claims Processing

Transmittal 1803   Change Request 6626

Dated August 28, 2009

Subject: October 2009 Update of the Hospital Outpatient Prospective Payment System (OPPS)

SUMMARY OF CHANGES: This Recurring Update Notification describes changes to and billing instructions for various payment policies implemented in the October 2009 OPPS update. The October 2009 Integrated Outpatient Code Editor (I/OCE) and OPPS Pricer will reflect the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code additions, changes, and deletions identified in this Change Request (CR).
October 2009 revisions to the I/OCE data files, instructions, and specifications are provided in CR 6618, October 2009 Integrated Outpatient Code Editor (I/OCE) Specifications Version 10.3.

1. Changes to Procedure and Device Edits for October 2009

2. Billing for Drugs, Biologicals, and Radiopharmaceuticals

3. Updating the OPSF for New CBSA and Wage Indices for Hospitals Receiving Section 508 Reclassification

4. Clarification Related to Condition Code 44 [see pages 15 – 17 of the document]

5. Coverage Determinations

New / Revised Material
Effective Date: October 1, 2009
Implementation Date: October 5, 2009

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