Question:

What is the effective date for the policy you reported in last week’s QA—the one related to reporting and charging requirements when a device is furnished without cost to the hospital etc.?

Answer:

This policy applies to claims with dates of service on and after January 1, 2014. As reported in the Medicare Claims Processing Manual, the hospital must report the amount of the device credit in the amount portion for value code “FD” (credit received from the manufacturer for a medical device). Also effective January 1, 2014 hospitals must report one of the following condition codes when the value code FD is present on the claim:

  • 49—product replacement within product lifecycle (replacement of a product earlier than the anticipated lifecycle)
  • 50—product replacement for known recall of a product (manufacturer or Food & Drug Administration [FDA] has identified the product for recall and therefore replacement)
  • 53— initial placement of a medical device provided as part of a clinical trial or free sample (code is for outpatient claims that have received a device credit upon initial medical device placement in a clinical trial or a free sample).
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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