July OPPS Update Features Many Code Changes
ICD10monitor June 17, 2024
The Centers for Medicare & Medicaid Services (CMS) has released the July 2024 Outpatient Prospective Payment System (OPPS) update. The MLN Matters number is MM13632, and the Change Request Number is CR13632.
This update takes effect on July 1.
On March 22, the Food and Drug Administration (FDA) released an Emergency Use Authorization (EUA) for emergency use of PEMGARDA (pemivibart) for pre-exposure prophylaxis of COVID-19. The HCPCS code is Q0224, and the administration code is M0224. The status indicator is “L” for Q0224, and it is not paid under the OPPS, but at “reasonable cost,” and the status indicator for M0224 is “S,” which means that it receives separate payment. The Ambulatory Payment Classification (APC) is 1506 (New Technology –...