Washington Administrative Code › Title 182 - Health Care Authority › WASHINGTON APPLE HEALTH › Chapter 182-550 - Hospital services › Section 182-550-1350 - Revenue code categories and subcategories - CPT and HCPCS reporting requirements for outpatient hospitals

Current through Register Vol. 24-14, July 15, 2024
(1)
				The medicaid agency requires an outpatient hospital provider to report the
				appropriate current procedural terminology (CPT) or health care common
				procedure coding system (HCPCS) codes in addition to the required revenue codes
				on an outpatient claim line when using any of the following revenue code
				categories and subcategories:
(a) "IV
				therapy," only subcategories "general classification" and "infusion
				pump";
(b) "Medical/surgical
				supplies and devices," only subcategory "other supplies/devices";
(c) "Oncology";
(d) "Laboratory";
(e) "Laboratory pathological";
(f) "Radiology - Diagnostic";
(g) "Radiology - Therapeutic and/or
				chemotherapy administration";
(h)
				"Nuclear medicine";
(i) "CT
				scan";
(j) "Operating room
				services," only subcategories "general classification" and "minor
				surgery";
(k) "Blood and blood
				components";
(l) "Administration,
				processing, and storage for blood components";
(m) "Other imaging services";
(n) "Respiratory services";
(o) "Physical therapy";
(p) "Occupational therapy";
(q) "Speech therapy - Language
				pathology";
(r) "Emergency room,"
				only subcategories "general classification" and "urgent care";
(s) "Pulmonary function";
(t) "Audiology";
(u) "Cardiology";
(v) "Ambulatory surgical care";
(w) "Clinic," only subcategories "general
				classification" and "other clinic";
(x) "Magnetic resonance technology
				(MRT)";
(y) "Medical/surgical
				supplies - Extension," only subcategory "surgical dressings";
(z) "Pharmacy - Extension" subcategories
				"Erythropoietin (EPO) less than ten thousand units," "Erythropoietin (EPO) ten
				thousand or more units," "drugs requiring detailed coding," and
				"self-administrable drugs";
(aa)
				"Labor room/delivery," only subcategories "general classification," "labor,"
				"delivery," and "birthing center";
(bb) "EKG/ECG (electrocardiogram)";
(cc) "EEG (electroencephalogram)";
(dd) "Gastro-intestinal services";
(ee) "Specialty room - Treatment/observation
				room," subcategory "treatment room and observation room";
(ff) "Telemedicine," only subcategory "other
				telemedicine";
(gg)
				"Extra-corporeal shock wave therapy (formerly lithotripsy)";
(hh) "Acquisition of body components," only
				subcategories "general classification" and "cadaver donor";
(ii) "Hemodialysis - Outpatient or home,"
				only subcategory "general classification";
(jj) "Peritoneal dialysis - Outpatient or
				home," only subcategory "general classification";
(kk) "Continuous ambulatory peritoneal
				dialysis (CAPD) - Outpatient or home," only subcategory "general
				classification";
(ll) "Continuous
				cycling peritoneal dialysis (CCPD) -Outpatient or home," only subcategory
				"general classification";
(mm)
				"Miscellaneous dialysis," only subcategories "general classification" and
				"ultrafiltration";
(nn) "Behavioral
				health treatments/services," only sub-category "electroshock therapy";
(oo) "Other diagnostic
				services";
(pp) "Other therapeutic
				services," only subcategories "general classification," "cardiac
				rehabilitation," and "other therapeutic service"; and
(qq) Other revenue code categories and
				subcategories identified and published by the agency.