2006 FI Update

2006 SNF CB Update for Services Billed to Fiscal Intermediaries for Payment

2006 First Quarterly Update

The codes below are listed as being added or removed from the 2006 annual update. This update is effective for claims with dates of service on or after 01/01/2006 unless otherwise noted below.

Major Category I. A. - Computerized Axial Tomography (CT) Scans

REMOVE - 76375

Major Category I. D. - Radiation Therapy

REMOVE - C9722, G0242, G0338

Major Category I. E. - Angiography, Lymphatic, Venous and Related Procedures

ADD - 36598

Note:  This code should be added to the SNF CB file effective April 1, 2006.

Major Category I. F. - Outpatient Surgery and Related Procedures--INCLUSION

REMOVE – 15810, 15811, G0345

Major Category I. H. - Ambulance Trips--With Application to Major Category II

REMOVE – Q3019, Q3020

Major Category II. A. - Dialysis Supplies

REMOVE – A4656  

Major Category III. B. -Chemotherapy Administration

ADD – 96409, 96411, 96413, 96415, 96416, 96417, C8953, C8954, C8955

REMOVE–96408, 96410, 96412, 96414, 96520, 96530, G0357, G0358, G0359, G0360, G0361, G0362

2006 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2006 and codes that have been discontinued for 2006. In addition, the file reflects any additions and deletions to categories of services excluded from consolidated billing.

The annual update file below contains the complete list of HCPCS codes that are excluded from SNF CB for claims submitted to Fiscal Intermediaries for payment.   Minor Surgery and Part B therapy inclusions are also included with this file.  This file is effective for claims with dates of service on or after 1/01/2006 unless otherwise noted below.

The following HCPCS coding changes were  made  with the 2006 Annual Update:

Major Category I. D.-Radiation Therapy

ADD - C9725 and C2637.

Major Category I. F.-Outpatient Surgery and Related Procedures-INCLUSION

ADD – 20979, G0345, 37195, 92977

REMOVE - 64550

Major Category II.A.3 (Dialysis) Coding Applicable to EPO and Aranesp Services

ADD – J0882, J0886

REMOVE – Q4054, Q4055

Major Category III. A. - Chemotherapy

ADD - J9025, J9027, J9035, J9098 (retroactive to 1/1/04), J9225, J9264

Major Category III. B. – Chemotherapy Administration

REMOVE - G0363

Major Category III. C. – Radioisotopes and their Administration

ADD – A9542, A9543, A9544, A9545

REMOVE – C1080, C1081, C1082 and C1083 (discontinued)

Major Category III. D. – Customized Prosthetic Devices

ADD - L5703, L5858, L5971, L6621, L6677, L7367, L7368, L7400, L7401, L7402, L7403, L7404, L7405

Major Category V. A. Therapies

ADD - 97760 (renumbered from 97504), 97761 (renumbered from 97520), 97762 (renumbered from 97703), 0019T

REMOVE - 96115, 97020 (combined with 97024), 97504 (renumbered to 97760), 97520 (renumbered to 97761), 97703 (renumbered to 97762), G0279, G0280

NOTE:  It is important and necessary for providers and FIs to view the Major Category Explanation file posted below in order to understand the Major Categories including additional exclusions that are not driven by HCPCS codes.