March 21, 2018

ACR Urges CMS to Change Several HOPPS Codes

On March 14, 2018, the American College of Radiology (ACR) met with representatives from the Division of Outpatient Care (DOC) at the Centers for Medicare and Medicaid Services (CMS) to discuss APC placement of new and bundled CPT codes for 2019 under the Hospital Outpatient Prospective Payment System (OPPS).

The ACR presented APC recommendations for CPT codes within the following services: Fine Needle Aspiration, Ultrasound Elastography, MR Elastography, Ultrasound with Contrast, MR Breast with CAD, Dilation and Placement PICC Line.

The ACR presented recommendations for APC placement based on predecessor codes and clinical homogeneity within each APC. Additionally, the ACR recommended several of CMS’ internally generated C-codes be deleted: C8904, C8907, C8905, C8908 and C9744, since the new CPT codes will represent upgrades to these MR and US temporary codes.

The ACR provided CMS with additional resources to assist them in the proper APC placement of the new CPT codes.

The College will continue to work with CMS to ensure proper APC placement of new and bundled CPT codes.