CMS releases OPPS, NCCI updates

Wednesday, September 25, 2024

CMS recently released the October 2024 update of the Outpatient Prospective Payment System (OPPS), which includes changes to various payment policies that will take effect on October 1. 

The update provides clarification on existing pass-through device categories and details status changes for certain Healthcare Common Procedure Coding System (HCPCS) codes. It also highlights status indicator changes for several Current Procedural Terminology (CPT®) codes.

In addition, the update includes information on coding and billing changes related to skin substitute and blood products, as well as drugs, biologicals, and radiopharmaceuticals.

Organizations should take note of the HCPCS and CPT coding changes that will take effect on October 1. Revenue integrity professionals can find more information on the October 2024 OPPS update in Medicare Claims Processing Transmittal 12816.

Along with releasing the latest OPPS update, CMS published the quarterly updates to the National Correct Coding Initiative (NCCI) edit files. Organizations can now access the latest versions of the add-on code, procedure-to-procedure, and medically unlikely edit files.

Editor’s note: Find more NAHRI coverage of NCCI edits here.

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