Nusgart Marcia
Alliance of Wound Care Stakeholders, Bethesda, Maryland.
Adv Wound Care (New Rochelle). 2018 Nov 1;7(11):358-362. doi: 10.1089/wound.2018.0826. Epub 2018 Nov 12.
Obtaining an appropriate Healthcare Common Procedure Coding System (HCPCS) code for a new product is the first step in a successful reimbursement strategy. However, applying for a new HCPCS code can be a frustrating, confusing, and complex process even for those who have prepared and submitted applications many times. Although the Centers for Medicare and Medicaid Services (CMS) staff provide excellent instructions for the various steps of the process (such as completing the application and presenting at the public meetings), the uninitiated and even veterans can learn tips from those who have been involved in this process for many years. The planning for a new HCPCS code should take place well in advance before the submission actually takes place. The company's reimbursement staff should be involved early in the product research and development and clinical trial discussions. This article addresses the strategy and activities that companies should undertake before applying for a new HCPCS code. In addition, the article also addresses key milestones in the HCPCS coding process, such as completing the HCPCS code application, attending, and speaking at the HCPCS public meeting.
为新产品获取合适的医疗保健通用程序编码系统(HCPCS)代码是成功报销策略的第一步。然而,即使对于那些多次准备和提交申请的人来说,申请新的HCPCS代码也可能是一个令人沮丧、困惑且复杂的过程。尽管医疗保险和医疗补助服务中心(CMS)的工作人员针对该过程的各个步骤提供了出色的指导(例如填写申请表并在公开会议上进行陈述),但无论是新手还是老手,都可以从那些多年来一直参与此过程的人那里学到技巧。在实际提交新的HCPCS代码申请之前,应该提前做好规划。公司的报销人员应尽早参与产品研发和临床试验讨论。本文阐述了公司在申请新的HCPCS代码之前应采取的策略和活动。此外,本文还阐述了HCPCS编码过程中的关键节点,例如完成HCPCS代码申请、参加HCPCS公开会议并在会上发言。