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2013 Part A MAC Update

2013 Annual Update

The SNF consolidated billing file reflects new codes that have been developed for 2013. 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 Fiscal Intermediaries/A/B 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 1/01/2013 unless otherwise noted below.

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

  • Add – 74174, 74261,74262

Major Category III. A. -Chemotherapy

  • Add – J9002, J9019, J9042
  • Remove – J9001

Major Category III.D – Customized Prosthetic Devices

  • Add – L5859

September 2013 Update:

Major Category I.F. – Minor Surgery INCLUSIONS

REMOVE (retroactive to January 1, 2013) – 11042, 11043 and 11044