2019 Part A MAC Update

2019 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2019. In addition, the file reflects additions 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 Part A MACs 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 1/1/2019 unless otherwise noted below.

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

REMOVE- 92977 (please include retro effective date of 1/1/17)

Major Category I. I. - Additional HCPCS EXCLUSIONS

ADD - 92977 (please include retro effective date of 1/1/17)

ADD - G0259 and G0260 (please include retro effective date of 1/1/17 for both codes)

Major Category III. A. -Chemotherapy

ADD - J9044, J9057, J9153, J9173, J9229, J9311, J9312, Q2041 and Q5107

REMOVE - J9310

Major Category III. D. - Customized Prosthetic Devices

ADD - L8701 and L8702

Major Category IV. J. - Initial Preventative Physical Exam

REMOVE - G0344 and G0367