General Question for the Week of May 29, 2017

General Compliance Question of the Week

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).

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.