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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

January 2013

Policy Reminder: HCPCS Level II C codes


As noted in the Outpatient Facility Fee Schedule Policy and the Coding Overview Payment Policy, Harvard Pilgrim does not accept HCPCS level II C codes, except for a limited number of codes that are specified on the hospital fee schedule.

As of January 1, 2013, the Centers for Medicare and Medicaid Services deleted HCPCS codes G0290 and G0291 used to bill for the placement of drug-eluting coronary stents and replaced them with a series of new C codes. Consistent with existing policy, Harvard Pilgrim will not accept these C codes. You may continue to bill and be reimbursed for the placement of stents (both drug-eluting and non-drug eluting); however, please use the applicable CPT code (92928-92944).

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network and Product Development

Joann Peck,
Manager, Network Planning and Administration

Annmarie Dadoly,
Editor

Kristin Edmonston,
Production Coordinator