rate of $130.19. In summary, after consideration of the public comments, CMS is reassigning CPT code 76145 to APC 5612 with a payment of $345.85.
MiVu Mucosal Integrity Testing System (APC 5303) For CY 2022, CMS proposed to continue to assign HCPCS code C9777 (Esophageal mucosal integrity testing by electrical impedance, transoral (list separately in addition to code for primary procedure)) to OPPS status indicator “N,” to indicate that the payment for HCPCS code C9777 is packaged into the payment for the primary procedure. CMS created HCPCS code C9777 to describe mucosal integrity testing by electrical impedance, based on their review of a New Technology APC application submitted by the manufacturer of the technology. HCPCS code C9777 was effective on April 1, 2021. Based on the application submitted to CMS and their initial review of the procedure, CMS believed the MiVu test to be performed with another primary procedure on the same day. Because the MiVu test is always performed as an add-on test to either an esophagoscopy or esophagogastroduodenoscopy, CMS established a C-code to appropriately describe the add-on component. Under the regulation at 42 CFR 419.2, payment for add-on codes is packaged or conditionally packaged into the payment for the related procedures or services under the OPPS. They believe that revising the long descriptor to describe the service of performing both the MiVu test with either an esophagoscopy or esophagogastroduodenoscopy on the same day would ensure accurate tracking and reporting of the service and minimize inappropriate reporting of the services. Consequently, effective January 1, 2022, CMS is revising the descriptor for HCPCS code C9777 to read “Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy,” to accurately reflect how the procedure is currently performed in the hospital outpatient setting. With the change in the descriptor for HCPCS code C9777, CMS is assigning HCPCS code C9777 to APC 5303 based on its resource and clinical homogeneity to the other procedures in the APC. CMS reminds hospitals that because HCPCS code C9777 describes both the MiVu test performed with either an esophagoscopy or esophagogastroduodenoscopy on the same day, HOPDs should not report separate HCPCS codes for the esophagoscopy or esophagogastroduodenoscopy. In summary, after consideration of the public comments, CMS is modifying the long descriptor for HCPCS code C9777, and reassigning HCPCS code C9777 to APC 5303 (Level 3 Upper GI Procedures) with a payment of $3,315.90 for CY 2022.
Pathogen Test(s) for Platelets (APC 5733) Starting in January 2021, CMS decided to assign P9100 to APC 5732 (Level 2 Minor Procedures) with a payment rate of approximately $33. From July 2017 until 2021, only one type of pathogen test for © 2022 Panacea Healthcare Solutions, Inc.
Summary of the CY2022 OPPS Final Rule
Software. Consulting. Education. Results.
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