2017 Part A MAC Update

2017 Annual Update:

The SNF consolidated billing file reflects new codes that have been developed for 2017. 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 1/1/2017 unless otherwise noted below.

Major Category III. C. -Radioisotopes and their Administration

REMOVE – A9544 and A9545

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

ADD – G0491, J0884

Major Category III. A. –Chemotherapy

ADD – J9034, J9145, J9176, J9205, J9295, J9301 (eff. 1/16), J9325 and J9352

Major Category IV. B. - Vaccines (Pneumococcal, Flu or Hepatitis B)

ADD – 90674        

Major Category IV. K. - Abdominal Aortic Aneurysms (AAA) Screening

ADD – 76706

REMOVE – G0389

Major Category V. A. - Therapies – INCLUSION

ADD – 97161, 97162, 97163, 97164, 97165, 97166, 97167 and 97168

REMOVE – 97001, 97002, 97003 and 97004