Wiki Add On Codes Non-Covered?

[KDurgin]

On the 2014 Medicare Fee Schedule for ASCs, all add-on codes have been removed. The codes remain on the Physician Fee Schedule. Codes are being denied as non-covered. Has anyone else experienced this? Does anyone have a record of prior notification to this BIG change? I've called Novitas, who handles our jurisdiction, and all they can tell me so far is that effective 1/1/14 the codes are non-covered.

 

[jennburgel]

add on codes

I bill for an ASC in NJ and we do not bill the add on's as they are considered
N1 if you go on the mcr / novitas website you can download fee sched, and a lis5t of covered codes by mcr. they will list them as N1 with no fee. Hope this helps.

 

[andicam30]

Yes, as of 1/1/14 add-on codes have been eliminated for reimbursement to ASCs. There was a comment period in 2013, to hopefully eliminate this decision; however, there was not enough ruffle in the ASC communities feathers to garner much support. Sadly, it is a significant cut for those smaller centers, and especially ones that serve a significantly large population of Medicare insured. Our center is 80% Medicare, we are getting hit big. I was hoping to see an increase in the primary procedure allowance to mitigate the elimination but that didn't happen either, only cut backs as per usual.

 

[KDurgin]

Thanks for the reply. We weren't aware this was a possibility for 2014, and I don't recall seeing it in any ASC newsletters.