September 26, 2008
October 2008 update of the hospital outpatient prospective payment system
Effective Date: October 1, 2008
Implementation Date: October 6, 2008
Summary
MLN Matters article MM6196 describes changes to and billing instructions for various payment policies implemented with the October 2008 outpatient prospective payment system (OPPS) update.
The October 2008 integrated outpatient code editor (I/OCE) software and OPPS PRICER reflect the healthcare common procedure coding system (HCPCS), ambulatory payment classification (APC), HCPCS modifier, and revenue code additions, changes, and deletions being identified in this notification. The October 2008 revisions to the I/OCE data files, instructions, and specifications are discussed in MLN Matters article MM6186 
.
.Following are the key changes effective with the October 1, 2008, update of the OPPS:
• Revenue code reporting
• Payment for radiology services reported with modifier 52
• Changes to procedure and device edits for October 2008
• Billing for devices
• Billing for medical and surgical supplies
• Billing for drugs, biologicals, and radiopharmaceuticals
• Payment for brachytherapy sources
• Mental health codes on partial hospitalization (PH/PHP) claims
• Coverage determinations
Source: CMS MLN Matters Article MM6196
