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Ask a Rev Cycle Expert: Is there a new HCPCS code for Hemospray®?

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Ask a Rev Cycle Expert
COVID-19 Coding & Billing

Question:

Is there a new HCPCS code for Hemospray®?

Answer:

Yes, Healthcare Common Procedure Coding System (HCPCS) code C1052 Hemostatic agent, gastrointestinal, topical has been given device pass-through status, effective January 1, 2021.

Transmittal 10541, January 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)

“…iii. We have determined the device offset amounts for APC 5302 (Level 2 Upper GI Procedures) and APC 5312 (Level 2 Lower GI Procedures) that are associated with the cost of the device category described by HCPCS code C1052 (Hemostatic agent, gastrointestinal, topical). The device in the category described by HCPCS code C1052 should always be billed with one of the following Current Procedural Terminology (CPT) codes:

  • CPT code 43227 (Esophagoscopy control bleed), which is assigned to APC 5302 for Calendar Year (CY) 2021;
  • CPT code 43255 (EGD control bleeding any), which is assigned to APC 5302 for Calendar Year (CY) 2021;
  • CPT code 44366 (Small bowel endoscopy), which is assigned to APC 5302 for Calendar Year (CY) 2021;
  • CPT code 44378 (Small bowel endoscopy), which is assigned to APC 5302 for Calendar Year (CY) 2021;
  • CPT code 44391 (Colonoscopy for bleeding), which is assigned to APC 5312 for Calendar Year (CY) 2021;
  • CPT code 45334 (Sigmoidoscopy for bleeding), which is assigned to APC 5312 for Calendar Year (CY) 2021;
  • CPT code 45382 (Colonoscopy w/control bleed), which is assigned to APC 5312 for Calendar Year (CY) 2021;…”

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).

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