March 13, 2019

ACR and Medicare Discuss Possible APC Placement of CPT Codes

American College of Radiology (ACR) officials met with representatives from the Division of Outpatient Care (DOC) at the Centers for Medicare and Medicaid Services (CMS) March 11, 2019, to discuss the ambulatory payment classification (APC) placement of new bundled CPT codes for 2020 under the Hospital Prospective Payment System (OPPS).

The ACR was represented by HOPPS/APC Committee Chairman Norman Thomson, MD, MBA; RUC Advisor Kurt Schoppe, MD; Senior Economic Advisor Pam Kassing and Economic Policy Analyst Christina Berry.

Discussion focused on new CPT codes that potentially could be bundled for the 2020 OPPS proposed rule.

The College’s team presented recommendations for APC-related CPT codes for gastrointestinal tract imaging, lumbar puncture and duplex scan arterial inflow. It suggested preferred options for APC placement based on predecessor codes and clinical homogeneity within each APC and provided CMS with additional resources to assist its staff with the proper APC placement of the new CPT codes.

The ACR will continue to work with CMS on this issue at least until the publication of the 2020 OPP final rules in November.