Annual Update to Home Health Consolidated Billing
September 4, 2014 10:02 AM
The Centers for Medicare and Medicaid Services (CMS) has issued their annual update of the Healthcare Common Procedure Coding System (HCPCS) codes used for home health (HH) consolidated billing through Change Request 8893.
HCPC codes A4459 (Manual Pump Enema System, Includes Balloon, Catheter and All Accessories, Reusable, Any Type) will be added to the consolidated billing list, effective January 1, 2015. CMS has added code A4459 due to its similarity to HCPCS code A4458 (reusable enema bag), which has been part of HH consolidated billing since 2003.
CMS periodically updates the lists of HCPCS codes that are subject to the consolidated billing provision of the Home Health Prospective Payment System (HH PPS). With the exception of therapies performed by physicians, supplies incidental to physician services and supplies used in institutional settings, services appearing on this list that are submitted on claims to Medicare contractors will not be paid separately on dates when a beneficiary for whom such a service is being billed is in a home health episode - i.e., under a home health plan of care administered by a home health agency.