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CMS Manual System
CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 11150 Date: December 10, 2021 Change Request 12552 SUBJECT: January 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS) I. SUMMARY OF CHANGES: This Recurring Update Notification describes changes to and billing instructions for various payment policies implemented in the January 2022 OPPS update. The January 2022 Integrated Outpatient code Editor (I/OCE) will reflect the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue code additions, changes, and deletions identified in this Change Request (CR). This Recurring Update Notification applies to Chapter 4, section (Annual Updates to the OPPS Pricer for Calendar Year (CY) 2007 and Later), and makes changes to sections and - (General Coding and Billing Instructions and Explanations) , to list the device category codes for present or previous pass-through payment and related terms and definitions.
On September 3, 2021, the AMA released eight new CPT Category I codes for reporting SARS-CoV-2 vaccines and their administration. CPT Codes 91305, 0051A, 0052A and 0053A are for reporting Pfizer-BioNTech COVID-19 vaccine and its administration for the tris-sucrose formulation. CPT Codes 0004A and
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