# APC changes for Nerve Injections



## dwaldman (Dec 20, 2015)

APCs   for outpatient hospital fee schedule for nerve injections/procedures 207,206,203,204 in 2015 have been deleted for 2015 and replaced with 5431-5432, 5441-5443

https://www.cms.gov/Medicare/Medica...entPPS/Addendum-A-and-Addendum-B-Updates.html

They took the epidural APC of 207 which was at 672.06 in 2015 and changed the epidurals to the new APC of 5442 of 585.17

The facets blocks 64490 64493 use to be in 2015 in the same APC as the epidural APC 207 they have now increased the facet block to APC 5443.

 They have lower the payment amount for RF Facet procedures from around $1470.00 to their new APC 5431 at an amount of $1392.56

 They have increase the amount of lysis one day 62264  of APC of 207 to the amount of APC 5443 

They have decrease the amount of the lysis 2 day 62263 to the exact amount of the lysis one day APC 5443

The pain pump refill  was at $247 previously and they have only dropped to $241 in 2016

Discogram CPT 72295 was moved from APC 0388 33275 to  APC 5526 2718.83

2016
5431 Level 1 Nerve Procedures $1,392.56
5432 Level 2 Nerve Procedures $3,396.78
5441 Level 1 Nerve Injections  $223.76
5442 Level 2 Nerve Injections $585.17
5443 Level 3 Nerve Injections $822.10

2015
0203 Level IV Nerve Injections  $1,470.03 
0204 Level I Nerve Injections  $211.21 
0205 Level III Male Genital Procedures T 46.0590 $3,416.33 
0206 Level II Nerve Injections T 5.0256 $372.76 
0207 Level III Nerve Injections T 9.0607 $672.06


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