Hospitals urge CMS to eliminate 'temporary' codes for nonphysician services

The American Hospital Association is calling on CMS to eliminate some "temporary codes" to ensure that coding and documentation requirements are consistent for outpatient billing.

Hospitals use healthcare procedure coding system level 2 codes primarily to bill for products, supplies and services not included in current procedural terminology codes, according to CMS. This includes billing for ambulance services, as well as medical equipment, prosthetics, orthotics and supplies that are not used in a physician's office.

In a letter to CMS Administrator Seema Verma sent Aug. 12, the hospital association said there are  "temporary codes" within level 2 codes, known as Q codes and G codes, which leads to more coding work and confusion.

"According to CMS, temporary codes are for the purpose of meeting, within a short time frame, the national program operational needs of a particular insurance sector that are not addressed by an already existing national code. However, some 'temporary' codes have remained in place for years. This disconnect results in confusion and additional work requiring different code assignments for the same service provided to Medicare patients vs. patients covered by commercial insurance," the hospital association wrote.

The hospital association specifically cited screening colonoscopies, for which Medicare uses healthcare procedure coding system level 2 codes and commercial payers require current procedural terminology codes.

Overall, the hospital association urged CMS to try to address the issue by eliminating or minimizing the use of "temporary" Q and G codes and ensuring that billing requirements are aligned with current procedural terminology codes so that all payers use the same national current procedural terminology code for billing the same service.

The hospital association's letter to CMS was in response to the federal government's request for input on reducing administrative burden.

Read the full letter here.

 

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