Under the Medicare hospital inpatient prospective payment system, each inpatient stay is assigned to a single Medicare severity diagnosis-related group (MS-DRG)20
Effective July 1, 2021, the Centers for Medicare and Medicaid Services (CMS) has established a permanent, product-specific HCPCS code for Kcentra®21
Code type | Procedure Code | HCPCS Code | Revenue Code | Diagnosis Code(s) |
Hospital inpatient setting | ICD-10-PCS 30283B1 | None | eg, 025X (for Kcentra) | Appropriate ICD-10-CM Diagnosis Code(s) |
Hospital outpatient and freestanding settings of care | Appropriate CPT code for Kcentra admin procedure | J7168 (Kcentra, per IU) | eg, 0636 (with J7168) + revenue code for admin CPT | Appropriate ICD-10-CM Diagnosis Code(s) |
*The codes being provided are from a complex and evolving medical coding system. The treating physician is solely responsible for diagnosis coding and determination of the appropriate ICD-10-CM codes that describe the patient's condition and are supported by the medical record. All codes provided are for informational purposes and are not an exhaustive list. The CPT®, HCPCS, ICD-10-CM, and ICD-10-PCS codes provided are based on AMA or CMS guidelines. The billing party is solely responsible for coding of services (eg, CPT coding). Because government and other third-party payer coding requirements change periodically, please verify current coding requirements directly with the payer being billed.
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