General Question for the Week of May 22, 2017

Question:

I have a comment to the answer posted to an April 10 question. You stated that, according to the Centers for Medicare & Medicaid Services (CMS), there is no cost to the hospital for a device being inserted and that modifier –FB must be appended to the procedure code (not the device code) under certain circumstances.

I had thought -FB was no longer a CMS requirement; rather the facility should utilize the correct condition code as well as the amount of credit in the “FD” value code?

Answer:

You are correct; the answer we provided was not the current policy, and we apologize for any inconvenience caused.

Detailed information about reporting and charging requirements when a device is furnished without cost to the hospital or when the hospital receives a full or partial credit for the replacement device can be found in the Medicare Claims Processing Manual, chapter 4, section 61.3.5 and 61.3.6 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c04.pdf. This policy took effect on January 1, 2014.