Galvanize PEF System 2024 Imbuyekezo kunye neKhowudi Isikhokelo somsebenzisi
IMVELAPHI
MALUNGA NE-ALIYA SYSTEM FOR PULSED FIELD ABLATION OF SOFT ITISSUE
Inkqubo ye-Aliya™ yenzelwe ukutshabalalisa izicubu ezithambileyo ngokuhanjiswa kweendawo zombane ezipholileyo (PEF) ukuze zijolise kwizicubu. Amandla aphezulu, ixesha elifutshane ahanjiswa kwithishu ekujoliswe kuyo ukubangela ukufa kweeseli ngelixa ugcina i-matrix engaphandle.
IZALATHISI ZOKUSETYENZISWA
Inkqubo ye-Aliya yi-510 (k) ihlanjululwe e-United States ukwenzela ukuchithwa kokuhlinzwa kwezicubu ezithambileyo.
INKCAZELO
I-Galvanize Therapeutics ayikhuthazi ukusetyenziswa kwe-label ye-off-label yeemveliso zayo kwaye akukho nto apha ijoliswe ekukhuthazeni ukusetyenziswa kwe-label ye-Aliya System. Inkqubo ye-Aliya sisixhobo sokukhupha utyando lwezicubu ezithambileyo, kwaye ayenzelwanga ukunyanga, ukunyanga, ukuthintela okanye ukunciphisa nasiphi na isifo okanye imeko ethile.
Ulwazi olunikiweyo luqulethe ulwazi lwembuyekezo jikelele kwaye lunikezelwe ngeenjongo zokubonisa. Ulwazi aluquki imbuyekezo okanye iingcebiso zomthetho. Luxanduva lomnikezeli kuphela ukugqiba ngemfuno yonyango, indawo efanelekileyo yokunikezelwa kwazo naziphi na iinkonzo, kunye nokungenisa iikhowudi ezichanekileyo nezifanelekileyo, iintlawulo kunye nezilungisi ezisekelwe kwiinkonzo ezinikezelwayo kunye nemeko yempilo yesigulane.
Ikwaluxanduva lomboneleli kuphela ukuqonda kunye nokuthobela i-Medicare national coverage determinations (NCD), i-Medicare local coverage determinations (LCD), kunye nazo naziphi na ezinye iimfuno ezikhethekileyo zokuhlawula umhlawuli ezisekwe ngabahlawuli abafanelekileyo. Iimfuno zokuhlawula umhlawuli, iikhowudi kunye nokhuseleko ziyahluka ukusuka kumhlawuli ukuya kumhlawuli, zinokuhlaziywa rhoqo, kwaye kufuneka zingqinwe phambi konyango ukuze kuthintelwe ukuxilongwa, ukukhowudwa, okanye iimfuno zenkonzo. IGalvanize Therapeutics icebisa ukuba udibane nabahlawuli, iingcali zembuyekezo, kunye/okanye nabacebisi bomthetho malunga nayo yonke ikhowudi, ukhuseleko, kunye nemicimbi yembuyekezo. Zonke iikhowudi kunye
ukungeniswa kweebhili kurhulumente wesigqeba kunye nawuphi na omnye umhlawuli kufuneka abe nenyaniso kwaye angakhohlisi, kwaye afune ukubhengezwa okupheleleyo kokubuyiselwa kwayo nayiphi na inkonzo okanye inkqubo. I-Galvanize Therapeutics ikhupha ngokukodwa uxanduva lwezenzo okanye iziphumo ezibangelwa kukusetyenziswa kolu lwazi.
CPT® Copyright 2024 American Medical Association. Onke amalungelo agciniwe i-CPT® luphawu lwentengiso yaseMelika
Umbutho wezoNyango. Iishedyuli zomrhumo, iiyunithi zexabiso elihambelanayo, izinto zokuguqulwa kunye / okanye izinto ezinxulumene nazo azibelwanga yi-AMA, aziyonxalenye ye-CPT®, kwaye i-AMA ayikukhuthazi ukusetyenziswa kwayo. I-AMA ayisebenzisi ngokuthe ngqo okanye ngokungathanga ngqo iyeza okanye ikhuphe iinkonzo zonyango. I-AMA ayithathi tyala ngedatha equlethweyo okanye engaqukwanga apha. Zonke iimpawu zokuthengisa ziyipropathi yabanini bazo.
INKCAZO
Ngaphambi kokusebenzisa i-Aliya System, nceda uphindeview Imiyalelo yokuSetyenziswa kuluhlu olupheleleyo lwezalathiso, izithintelo, izilumkiso, izilumkiso kunye neziganeko ezinokuba zibi. Ukufumana ulwazi olupheleleyo lokumisela, nceda undwendwele www.galvanizetherapeutics.com.
UGQIRHA, ISIGULI SESIBHEDLELE, KUNYE NE-ASC CODING
| I-Medicare 2024 yeSizwe yeNtlawulo (Ayilungiswanga ngokweJografi) | ||||||||
| Inkonzo ebonelelweyo | IShedyuli yeNtlawulo kaGqirha1 | I-ASC2Payment/Isalathisi | Isibhedlele3 | |||||
| CPT® | Inkcazo | Indawo engeyiyo (OBL) | Isixhobo (-26) | APC / Isalathisi APC / Isalathisi | I-OPPSPayment | |||
| 0600T* | I-Ablation, i-electroporation engenakuguqulwa; I-1 okanye i-tumor ngaphezulu kwi-organ, kubandakanywa isikhokelo sokucinga, xa senziwa, i-percutaneous (Musa ukuxela i-0600T ngokubambisana ne-76940, 77002, 77013, 77022) | Akukho ntlawulo yesizwe isekiweyo | $ 6604 | J8 | 5362 | J1 | $9808 | |
| 0601T* | I-Ablation, i-electroporation engenakuguqulwa; I-1 okanye izicubu ezingaphezulu, ezibandakanya i-fluoroscopic kunye ne-ultrasound guided, xa yenziwe, ivule (Musa ukubika i-0601T ngokubambisana ne-76940, i-77002) | Akukho ntlawulo yesizwe isekiweyo | $6 | J8 | 5362 | J1 | $9808 | |
*2024 CPT® Professional. Isigama seNkqubo yangoku (CPT®) yi-copyright 1966, 1970, 1973, 1977, 1981, 1983-2022 yiAmerican Medical Association. Onke Amalungelo Agciniwe. I-CPT® luphawu lokuthengisa olubhalisiweyo lwe-American Medical Association (AMA).
UDIDI III CPT® IIKHOWUDI
Inkqubo ye-Aliya ye-PEF inokuxelwa ngokusebenzisa i-Category III CPT® codes kwitheyibhile engentla. Ezi khowudi
chaza ngokuthe ngqo i-electroporation engenakubuyiseka yamathumba ngendlela ye-percutaneous okanye evulekileyo. Ukuba kukhona enye
olunye uhlobo lwe-laproscopic, endoscopic, okanye indlela ye-bronchoscopic yenziwa ikhowudi yenkqubo engadweliswanga
inokuxelwa. Iikhowudi zeCPT® ezingabhalwanga okanye "ezingachazwanga ngenye indlela" iikhowudi zeCPT® zivumela oogqirha ukuba banike ingxelo
iinkqubo ezingenayo ikhowudi ye-CPT® ethe ngqo. Ukunika ingxelo ngekhowudi engadweliswanga ngokuchanekileyo ngokufanelekileyo
amaxwebhu avumela oogqirha kunye nezibhedlele ukuba bangenise ikhowudi yenkqubo engenalo olucacileyo
CPT® ikhowudi. Iinkqubo ezichazwe yi-CPT® 0600T kunye ne-0601T ziquka iinkqubo zesikhokelo somfanekiso. Isikhokelo somfanekiso Iikhowudi ze-CPT® azifakwanga ngokwahlukeneyo kwi-CMS Form 1500 ifom yebango.
Udidi lwe-III CPT® Iikhowudi ziikhowudi zesikhashana zobuchwepheshe obuvelayo, iinkonzo kunye neenkqubo ezivumelayo
ukuqokelelwa kwedatha ethile enxulumene nezo nkonzo kunye neenkqubo. Ngokutsho kwe-AMA CPT®, ukuba ikhowudi yeCandelo III iyafumaneka, kufuneka ixelwe endaweni yeCandelo I code1 engabhalwanga.
Akukho RVU eyabelweyo okanye intlawulo kagqirha esekiweyo kwezi khowudi ze-CPT® zeCandelo III.
Ukubuyisela kugqirha kukubona komhlawuli. Abahlawuli banokucela amaxwebhu okusebenza kweklinikhi ukuxhasa ukhuseleko. Abahlawuli abasebenzise iikhowudi ze-IRE ezintsha zeCandelo III banokucela amaxwebhu okusebenza kweklinikhi ukuxhasa ukhuseleko. Ezi zinto zilandelayo ziyacetyiswa ukuxhasa ukufakwa kwebango lakho:
- Ikopi yengxelo yokusebenza
- Ileta yemfuno yonyango
- Ikopi yeleta yemvume ye-FDA
Xa uhambisa ikhowudi ye-III CPT®, kucetyiswa ukuba ababoneleli bangenise uluhlu olubalisayo lwekhowudi yeCandelo I-CPT® abavakalelwa kukuba ifaniswa ngexesha, umgudu, ubunzima, kunye nexabiso kwinkonzo enikeziweyo, ebonisa ukuba umhlawuli uxabisa inkonzo. imelwe yikhowudi ye-III CPT® esekelwe kwixabiso elinikezelwe kule khowudi yeCandelo I-CPT®. Kuya kubaluleka ukubhala iinkonzo ezinikezelweyo ngokwezibonelelo kunye nexesha lokuqwalaselwa kwentlawulo efanelekileyo yecandelo lobuchwephesha benkqubo.
LE IMITHETHO ENGEZANTSI UNGAQINISEKI, UCINGE, OKANYE UJOLISWE UKUSETYENZISWA KWESI XHOBO NGOKUBANZI KUYO NAYIPHI NA INDAWO EKHETHEKILEYO YE-ANATOMICAL OKANYE KULO NALUPHI UNYANGO LWEMPILO. ESI SIKHOKELO SOKUBUYISELWA KWEMBUYEKEZO KUPHELA SIJONGE KUPHELA UKUCHAZA IINDAWO EZIPHAMBILI NGOKUPHAMBILI KWEZIKHUMBA.
I-KIDNEY ICD-10-PCS IIKHOWUDI KUNYE NE-MS-DRGS
Iikhowudi ze-ICD-10-PCS (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi ezidwelisiweyo ze-ICD-10-PCS zi-exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo zokuchithwa kwezintso.4 ICD-10-PCS nganye inokudityaniswa phantsi kwe-Medicare Severity-Diagnosis Related Group (MS-DRGs) .5
| Ikhowudi | ICD-10-PCS Inkcazo4 | I-MS-DRG5 |
| 0T500ZZ | Ukutshatyalaliswa kwezintso zasekunene, indlela evulekileyo | 656 – 661 |
| 0T503ZZ | Ukutshatyalaliswa kwezintso zasekunene, indlela ye-percutaneous | 656 – 661 |
| 0T504ZZ | Ukutshatyalaliswa kwezintso zasekunene, i-percutaneous endoscopic approach | 656 – 661 |
| 0T510ZZ | Ukutshatyalaliswa kwezintso zasekhohlo, indlela evulekileyo | 656 – 661 |
| 0T513ZZ | Ukutshatyalaliswa kwezintso zasekhohlo, indlela ye-percutaneous | 656 – 661 |
| 0T514ZZ | Ukutshatyalaliswa kwezintso zasekhohlo, indlela endoscopic percutaneous | 656 – 661 |
| 0T530ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekunene, indlela evulekileyo | 656 – 661 |
| 0T533ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekunene, indlela ye-percutaneous | 656 – 661 |
| 0T534ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekunene, i-percutaneous endoscopic approach | 656 – 661 |
| 0T540ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekhohlo, indlela evulekileyo | 656 – 661 |
| 0T543ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekhohlo, indlela ye-percutaneous | 656 – 661 |
| 0T544ZZ | Ukutshatyalaliswa kwe-pelvis yezintso zasekhohlo, i-percutaneous endoscopic approach | 656 – 661 |
I-Medicare Severity-Diagnosis Related Groups (MS-DRGs)5,6 (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Ezi zilandelayo ze-MS-DRGs zinokusebenza kwiinkqubo zokukhupha izintso kwizigulane ze-Medicare. Ezinye iikhowudi zokuxilongwa kwesibini ezihambelana neemeko ezongezelelweyo ngexesha lokungeniswa okanye ukuphuhliswa emva koko, kunye nefuthe kwiinkqubo ezenziweyo okanye ubude bokuhlala ngexesha lokungeniswa kwesigulane esifanayo, kunokuchazwa.
| I-MS-DRG5 | I-MS-DRG Inkcazo | Isihlobo Ubunzima Intlawulo yesibhedlele | |
| 656 | INKQUBO YEZINTSO NE-URETER YE-NEOPLASM W/MCC | 3 . 1 | $21,968 |
| 657 | INKQUBO YEZINTSO NE-URETER YE-NEOPLASM W/CC | 1 . 8 | $ 12 9 |
| 658 | INKQUBO YEZINTSO NE-URETER YE-NEOPLASM W/O CC/MCC | 1 . 4 | $10,365 |
| 659 | INKQUBO YEZINTSO NE-URETER YOKUNGEKHO NEOPLASM W/ MCC | 2 . 58 | $ 1 8 ,126 |
| 660 | INKQUBO YEZINTSO NE-URETER YOKUNGEKHO NEOPLASM W/ CC | 1 . 3 | $ 9 , 4 2 3 |
| 661 | INKQUBO YEZINTSO NE-URETER YOKUNGEKHO NEOPLASM W/O CC/MCC | 1 .0 4 8 4 | $ 7, 3 4 0 |
I-ICD-10-CM7 Iikhowudi zokuHlola (OCT 1, 2023 ukuya kwi-SEPT 30, 2024)
Iikhowudi zokuxilongwa kwe-ICD-10-CM ezidweliswe zi exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo zokukhupha izintso.
| Ikhowudi | I-ICD-10-CM Inkcazo (Uxilongo Iikhowudi) |
| C64.1 | I-neoplasm enobungozi kwizintso zasekunene, ngaphandle kwe-pelvis yezintso |
| C64.2 | I-neoplasm enobungozi kwizintso zasekhohlo, ngaphandle kwe-pelvis yezintso |
| C64.9 | I-neoplasm enobungozi kwizintso ezingachazwanga, ngaphandle kwe-pelvis yezintso |
| C65.1 | I-neoplasm enobungozi kwi-pelvis ye-renal yasekunene |
| C65.2 | I-neoplasm enobungozi kwi-pelvis ye-renal yasekhohlo |
| C65.9 | I-neoplasm enobungozi ye-pelvis ye-renal engachazwanga |
| C79.00 | I-neoplasm ye-secondary malignant yezintso ezingachazwanga kunye ne-renal pelvis |
| C79.01 | I-neoplasm enobungozi yesibini ye-right kidney kunye ne-renal pelvis |
| C79.02 | I-neoplasm ye-secondary malignant yezintso zasekhohlo kunye ne-renal pelvis |
| C7A.093 | Ithumba eliyingozi le-carcinoid yezintso |
| C80.2 | I-neoplasm enobungozi ehambelana nelungu lokutshintshwa |
I-LIVER ICD-10-PCS CODES KUNYE NE-MS-DRGS
Iikhowudi ze-ICD-10-PCS (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi ezidwelisiweyo ze-ICD-10-PCS zi-exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo zokuchithwa kwesibindi.4 I-ICD-10-PCS nganye inokudityaniswa phantsi kwe-Medicare Severity-Diagnosis Related Group (MS-DRGs).5
| Ikhowudi | ICD-10-PCS Inkcazo4 | I-MS-DRG5 |
| 0F500ZF | Ukutshatyalaliswa kwesibindi usebenzisa i-electroporation engenakuguqulwa, indlela evulekileyo | 356-358, 405-407 |
| 0F503ZF | Ukutshatyalaliswa kwesibindi kusetyenziswa i-electroporation engenakuguqulwa, indlela ye-percutaneous | 356-358, 405-407 |
| 0F504ZF | Ukutshatyalaliswa kwesibindi kusetyenziswa i-electroporation engaguqukiyo, indlela ye-percutaneous endoscopic | 356-358, 405-407 |
| 0F510ZF | Ukutshatyalaliswa kwesibindi se-lobe yasekunene usebenzisa i-electroporation engaguqukiyo, indlela evulekileyo | 356-358, 405-407 |
| 0F513ZF | Ukutshatyalaliswa kwesibindi se-lobe yasekunene usebenzisa i-electroporation engaguqukiyo, indlela ye-percutaneous | 356-358, 405-407 |
| 0F514ZF | Ukutshatyalaliswa kwesibindi se-lobe yasekunene usebenzisa i-electroporation engaguqukiyo, indlela ye-percutaneous endoscopic | 356-358, 405-407 |
| 0F520FZ | Ukutshatyalaliswa kwesibindi se-lobe ekhohlo usebenzisa i-electroporation engaguqukiyo, indlela evulekileyo | 356-358, 405-407 |
| 0F523FZ | Ukutshatyalaliswa kwesibindi se-lobe ekhohlo usebenzisa i-electroporation engaguqukiyo, indlela ye-percutaneous | 356-358, 405-407 |
| 0F524FZ | Ukutshatyalaliswa kwesibindi se-lobe ekhohlo kusetyenziswa i-electroporation engaguqukiyo, i-percutaneous endoscopic approach | 356-358, 405-407 |
I-Medicare Severity-Diagnosis Related Groups (MS-DRGs)5,6 (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Ezi zilandelayo ze-MS-DRGs zinokusebenza kwiinkqubo zokukhupha isibindi kwizigulane ze-Medicare. Ezinye iikhowudi zokuxilongwa kwesibini ezihambelana neemeko ezongezelelweyo ngexesha lokungeniswa okanye ukuphuhliswa emva koko, kunye nefuthe kwiinkqubo ezenziweyo okanye ubude bokuhlala ngexesha lokungeniswa kwesigulane esifanayo, kunokuchazwa.
| I-MS-DRG5 | I-MS-DRG Inkcazo | Isihlobo Ubunzima Intlawulo yesibhedlele | |
| 356 | ENYE INKQUBO YOKWEYISA OKANYE IINKQUBO W/ MCC | 4 . 2787 | $29,958 |
| 357 | ENYE INKQUBO YOKWEYISA OKANYE IINKQUBO W/ CC | 2 .1 9 6 8 | $ 15 , 381 |
| 358 | EZINYE INKQUBO YOKUCOYWA OKANYE IINKQUBO W/O CC/MCC | 1 . 28 | $ 8 , 9 7 0 |
| 405 | IINKQUBO ZE-PAANCRE, ISIBINDI & NE-SHUNT W/ MCC | 5 . 5052 | $38,545 |
| 406 | IINKQUBO ZE-PAANCRE, ISIBINDI NE-SHUNT W/ CC | 2 . 8 | $20 |
| 407 | IINKQUBO ZE-PAANCRE, ISIBINDI & SHUNT W/O CC/MCC | 2 . 1 5 1 0 | $15,060 |
I-ICD-10-CM7Iikhowudi zokuxilonga (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi zokuxilongwa kwe-ICD-10-CM ezidweliswe zi exampiikhowudi ezinokuthi zifake isicelo kwiinkqubo zokukhutshwa kwesibindi.
| Ikhowudi | I-ICD-10-CM Inkcazo (Uxilongo Iikhowudi) |
| C22.0 | I-Carcinoma yesibindi sesibindi |
| C22.1 | I-intrahepatic bile duct carcinoma |
| C22.2 | Hepatoblastoma |
| C22.3 | I-Angiosarcoma yesibindi |
| C22.4 | Ezinye i-sarcomas zesibindi |
| C22.7 | Ezinye i-carcinomas ezichaziweyo zesibindi |
| C22.8 | I-neoplasm embi yesibindi, eyona nto iphambili, engachazwanga malunga nokuchwetheza |
| C22.9 | I-neoplasm embi yesibindi, engachazwanga njengeprayimari okanye yesibini |
| C78.7 | I-neoplasm eyingozi yesibini yesibindi kunye ne-intrahepatic bile duct |
| C7A.098 | Amathumba e-carcinoid anobungozi kwezinye iisayithi |
| C7A.1 | Amathumba e-neuroendocrine ahluke kakubi |
| C7A.8 | Amanye amathumba e-neuroendocrine ayingozi |
| C7B.02 | Amathumba e-carcinoid yesibini yesibindi |
| C7B.8 | Ezinye izicubu ze-neuroendocrine zesibini |
| D01.5 | I-Carcinoma kwindawo yesibindi, i-gallbladder kunye ne-bile ducts |
AMALUNGA ICD-10-PCS IIKHOWUDI KUNYE NE-MS-DRGS
Iikhowudi ze-ICD-10-PCS (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi ezidwelisiweyo ze-ICD-10-PCS zi-exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo zokukhupha imiphunga.4 0I-ICD-10-PCS nganye inokudityaniswa phantsi kwe-Medicare Severity-Diagnosis Related Group (MS-DRGs).5
| Ikhowudi | ICD-10-PCS Inkcazo4 | I-MS-DRG5 |
| 0B533ZZ | Ukutshatyalaliswa kwe-Right Main Bronchus, i-Percutaneous Approach | 163 – 165 |
| 0B543ZZ | Ukutshatyalaliswa kwe-Right Upper Lobe Bronchus, i-Percutaneous Approach | 163 – 165 |
| 0B553ZZ | Ukutshatyalaliswa kweRight Middle Lobe Bronchus, iPercutaneous Approach | 163 – 165 |
| 0B563ZZ | Ukutshatyalaliswa kweLobe esezantsi yeBronchus, iPercutaneous Approach | 163 – 165 |
| 0B573ZZ | Ukutshatyalaliswa kweBronchus eNkohlo, iPercutaneous Approach | 163 – 165 |
| 0B583ZZ | Ukutshatyalaliswa kwe-Left Upper Lobe Bronchus, i-Percutaneous Approach | 163 – 165 |
| 0B593ZZ | Ukutshatyalaliswa kweLingula Bronchus, iPercutaneous Approach | 163 – 165 |
| 0B5B3ZZ | Ukutshatyalaliswa kweLeft Lower Lobe Bronchus, iPercutaneous Approach | 163 – 165 |
| 0B5C3ZZ | Ukutshatyalaliswa kweLobe yeLung ePhezulu, iPercutaneous Approach | 166 – 168 |
| 0B5D3ZZ | Ukutshatyalaliswa kweLung Lobe yeLung, i-Percutaneous Approach | 166 – 168 |
| 0B5F3ZZ | Ukutshatyalaliswa kweLung Lobe yeMiphuphu ePhantsi, i-Percutaneous Approach | 166 – 168 |
| 0B5G3ZZ | Ukutshatyalaliswa kweLobe yeLung ePhezulu eKhohlo, i-Percutaneous Approach | 166 – 168 |
| 0B5H3ZZ | Ukutshatyalaliswa kweLung Lingula, iPercutaneous Approach | 166 – 168 |
| 0B5J3ZZ | Ukutshatyalaliswa kweLobe yeMiphuphu esezantsi, iPercutaneous Approach | 166 – 168 |
| 0B5K3ZZ | Ukutshatyalaliswa kweLung Lung, i-Percutaneous Approach | 166 – 168 |
| 0B5L3ZZ | Ukutshatyalaliswa kwemiphunga yaKhohlo, iPercutaneous Approach | 166 – 168 |
| 0B5M3ZZ | Ukutshatyalaliswa kweMiphuphu yeBilateral, iPercutaneous Approach | 166 – 168 |
| 0B5N3ZZ | Ukutshatyalaliswa kwe-Right Pleura, i-Percutaneous Approach | 163 – 165 |
| 0B5P3ZZ | Ukutshatyalaliswa kwe-Left Pleura, i-Percutaneous Approach | 163 – 165 |
| 0B5T3ZZ | Ukutshatyalaliswa kweDiphragm, i-Percutaneous Approach | 163 – 165 |
| 0B5_0ZZ | Ukutshatyalaliswa kwe [jonga ngasentla], i-Open Approach | 163 – 165 |
I-Medicare Severity-Diagnosis Related Groups (MS-DRGs)5,6 (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Ezi zilandelayo ze-MS-DRGs zinokusebenza kwiinkqubo zokukhupha imiphunga kwizigulane ze-Medicare. Ezinye iikhowudi zokuxilongwa kwesibini ezihambelana neemeko ezongezelelweyo ngexesha lokungeniswa okanye ukuphuhliswa emva koko, kunye nefuthe kwiinkqubo ezenziweyo okanye ubude bokuhlala ngexesha lokungeniswa kwesigulane esifanayo, kunokuchazwa.
| I-MS-DRG3 | I-MS-DRG Inkcazo | Isihlobo Ubunzima Intlawulo yesibhedlele | |
| 163 | IINKQUBO EZINGUNDOQO YESIFUBA W/ MCC | 4 . 7 | $33,003 |
| 164 | IINKQUBO EZINGUNDOQO YEZIFUBA W/ CC | 2.5504 | $1 7, 85 7 |
| 165 | IINKQUBO EZINGUNDOQO YEZIFUBA W/O CC/MCC | 1.8 76 4 | $ 13 , 13 8 |
| 166 | ENYE INKQUBO YE-RESP OKANYE IINKQUBO W/MCC | 4.0578 | $ 2 8 , 41 1 |
| 167 | ENYE INKQUBO YE-RESP OKANYE IINKQUBO W/CC | 1 . 8198 | $ 12 , 742 |
| 168 | ENYE INKQUBO YE-RESP OKANYE IINKQUBO W/O CC/MCC | 1 . 35 | $94 |
I-ICD-10-CM7Diagnosis Codes (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi zokuxilongwa kwe-ICD-10-CM ezidweliswe zi exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo zokukhupha imiphunga.
| Ikhowudi | ICD-10-PCS Inkcazo4 |
| C34.00 | I-neoplasm embi ye-bronchus engundoqo engachazwanga |
| C34.01 | I-neoplasm embi ye-bronchus engundoqo yasekunene |
| C34.02 | I-neoplasm embi ye-bronchus engundoqo yasekhohlo |
| C34.10 | I-neoplasm enobungozi ye-lobe ephezulu, i-bronchus engachazwanga okanye imiphunga |
| C34.11 | I-neoplasm enobungozi ye-lobe ephezulu, i-bronchus yasekunene okanye imiphunga |
| C34.12 | I-neoplasm enobungozi ye-lobe ephezulu, i-bronchus ekhohlo okanye imiphunga |
| C34.2 | I-neoplasm embi ye-lobe ephakathi, i-bronchus okanye imiphunga |
| C34.30 | I-neoplasm enobungozi ye-lobe ephantsi, i-bronchus engachazwanga okanye imiphunga |
| C34.31 | I-neoplasm enobungozi ye-lobe ephantsi, i-bronchus yasekunene okanye imiphunga |
| C34.32 | I-neoplasm enobungozi ye-lobe ephantsi, i-bronchus ekhohlo okanye imiphunga |
| C34.80 | I-neoplasm enobungozi yeendawo ezidibeneyo, i-bronchus engachazwanga okanye imiphunga |
| C34.81 | I-neoplasm enobungozi yeendawo ezidibanayo, i-bronchus yasekunene okanye imiphunga |
| C34.82 | I-neoplasm enobungozi yeendawo ezidibeneyo, i-bronchus ekhohlo okanye imiphunga |
| C34.90 | I-neoplasm enobungozi yengxenye engachazwanga, i-bronchus engachazwanga okanye imiphunga |
| C34.91 | I-neoplasm enobungozi yengxenye engachazwanga, i-bronchus yasekunene okanye imiphunga |
| C34.92 | I-neoplasm enobungozi yengxenye engachazwanga, i-bronchus ekhohlo okanye imiphunga |
| C37 | I-neoplasm enobungozi ye-thymus |
| C38.4 | I-neoplasm embi ye-pleura |
| C45.0 | I-Mesothelioma ye-pleura |
| C76.1 | I-neoplasm embi ye-thorax |
| C78.00 | I-neoplasm enobungozi yesibini yemiphunga engachazwanga |
| C78.01 | I-neoplasm eyingozi yesibini yemiphunga yasekunene |
| C78.02 | I-neoplasm eyingozi yesibini yomphunga wasekhohlo |
| C78.1 | I-neoplasm eyingozi yesibini ye-mediastinum |
| C7A.090 | Ithumba eliyingozi le-carcinoid ye-bronchus kunye nemiphunga |
| C7A.091 | Ithumba eliyingozi le-carcinoid ye-thymus |
| D02.20 | I-Carcinoma kwi-situ ye-bronchus engachazwanga kunye nemiphunga |
| D02.21 | I-Carcinoma kwi-situ ye-bronchus yasekunene kunye nemiphunga |
| D02.22 | I-Carcinoma kwi-situ ye-bronchus yasekhohlo kunye nemiphunga |
| D38.1 | I-Neoplasm yokuziphatha okungaqinisekanga kwe-trachea, i-bronchus kunye nemiphunga |
| D38.2 | I-Neoplasm yokuziphatha okungaqinisekanga kwe-pleura |
| D38.3 | I-neoplasm yokuziphatha okungaqinisekanga kwe-mediastinum |
| D38.4 | I-neoplasm yokuziphatha okungaqinisekanga kwe-thymus |
PANCREAS ICD-10-PCS IIKHOWUDI NE-MS-DRGS
Iikhowudi ze-ICD-10-PCS (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi ezidwelisiweyo ze-ICD-10-PCS zi-exampiikhowudi ezinokuthi zifake izicelo kwiinkqubo ze-pancreas ablation.4 I-ICD-10-PCS nganye inokudityaniswa phantsi kwe-Medicare Severity-Diagnosis Related Group (MS-DRGs).5
| Ikhowudi | ICD-10-PCS Inkcazo4 | I-MS-DRG5 |
| 0F5G0ZF | Ukutshatyalaliswa kwe-pancreas usebenzisa i-electroporation engenakuguqulwa, indlela evulekileyo | 405-407, 628-630 |
| 0F5G3ZF | Ukutshatyalaliswa kwe-pancreas usebenzisa i-electroporation engenakuguqulwa, indlela ye-percutaneous | 405-407, 628-630 |
| 0F5G4ZF | Ukutshatyalaliswa kwe-pancreas usebenzisa i-electroporation engenakuguqulwa, indlela ye-percutaneous endoscopic | - |
I-Medicare Severity-Diagnosis Related Groups (MS-DRGs)5,6 (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Ezi zilandelayo ze-MS-DRGs zinokusebenza kwiinkqubo zokukhutshwa kwe-pancreas kwizigulane ze-Medicare. Ezinye iikhowudi zokuxilonga zesibini ezihambelana neemeko ezongezelelweyo ngexesha lokungeniswa okanye ukuphuhliswa emva koko, kunye nefuthe kwiinkqubo ezenziweyo okanye ubude bokuhlala ngexesha lokungeniswa kwesigulane esifanayo, kunokuchazwa.
| I-MS-DRG3 | I-MS-DRG Inkcazo | Isihlobo Ubunzima Intlawulo yesibhedlele | |
| 405 | I-PAANCRE, Isibindi, & NEENKQUBO ZOKUTSHINTSHA W/ MCC | 5 . 5052 | $38,545 |
| 406 | I-PAANCRE, Isibindi, & NEENKQUBO ZOKUTSHINTSHA W/ CC | 2 . 8 | $20,216 |
| 407 | I-PAANCRE, Isibindi, & NEENKQUBO ZE-SHUNT W/O CC/MCC | 2 . 1 5 1 0 | $15,060 |
| 628 | EZINYE I-ENDOCRINE, NUTRIT & METAB OKANYE IPROC W/ MCC | 4 .01 4 5 | $28,108 |
| 629 | EZINYE i-ENDOCRINE, i-NUTRIT & METAB OKANYE I-PROC W/ CC | 2 . 2628 | $15,843 |
| 630 | EZINYE I-ENDOCRINE, NUTRIT & METAB OKANYE IPROC W/O CC/MCC | 1 . 39 | $ 9, 7 7 6 |
I-ICD-10-CM7Diagnosis Codes (OCT 1, 2023 ukuya kuSEPT 30, 2024)
Iikhowudi zokuxilongwa kwe-ICD-10-CM ezidweliswe zi exampiikhowudi ezinokuthi zifake isicelo kwiinkqubo zokukhupha i-pancreas.
| I-MS-DRG3 | I-ICD-10-CM Inkcazo (Uxilongo Iikhowudi) |
| C25.0 | I-neoplasm embi yentloko ye-pancreas |
| C25.1 | I-neoplasm enobungozi emzimbeni we-pancreas |
| C25.2 | I-neoplasm enobungozi yomsila we-pancreas |
| C25.3 | I-neoplasm embi ye-pancreatic duct |
| C25.4 | I-neoplasm enobungozi ye-endocrine pancreas |
| C25.7 | I-neoplasm enobungozi kwezinye iindawo ze-pancreas |
| C25.8 | I-neoplasm enobungozi yeendawo ezidibanayo ze-pancreas |
| C25.9 | I-neoplasm embi ye-pancreas, engachazwanga |
INKXASO YOKUBUYISELWA
Ngemibuzo malunga nekhowudi, i-inshorensi, intlawulo kunye nolunye ulwazi lwembuyekezo, nceda uqhagamshelane nathi ku: AliyaReimbursement@galvanizetx.com.
IREMINOLOJI YOKUBUYISELWA
| Ixesha | Inkcazo |
| CMS | Amaziko eMedicare kunye neeNkonzo zeMedicaid |
| ASC | Iziko loNyango lweAmbulatory |
| OPPS | Inkqubo yeNtlawulo elindelekileyo yabaguli bangaphandle |
| APC | Ukuhlelwa kweNtlawulo ye-Ambulatory |
| J1 | Ihlawulwe phantsi kwe-OPPS; zonke iinkonzo zeCandelo B ezikhuselweyo kwibango zipakishwe nenkonzo engundoqo “J1” yebango, ngaphandle kweenkonzo ezinesimo sesalathisi se-OPPS sika-“F,” “G,” “H,” “L” no-“U”; iinkonzo zeambulensi; ukuxilongwa kunye nokuhlolwa kwe-mammography; iinkonzo zonyango lokubuyisela kwisimo sangaphambili; iinkonzo ezabelwe iteknoloji entsha ye-APC; iziyobisi ozisebenzisayo; zonke iinkonzo zothintelo; kunye neenkonzo ezithile zeCandelo B lezigulana. |
| J8 | Inkqubo engqongqo kwisixhobo; ihlawulwe ngereyithi ehlengahlengisiweyo |
| I-ICD-10-CM | Ulwahlulo lwamazwe ngamazwe lweZifo, uHlaziyo lwe-10, ukuguqulwa kwezonyango |
| ICD-10-PCS | Ulwahlulo lwamazwe ngamazwe lweZifo, uHlaziyo lwe-10, iNkqubo yokuKhowuda iNkqubo |
| IPPS | Inkqubo yeNtlawulo elindelekileyo yezigulana |
| I-MS-DRG | Iqela leMedicare Severity Diagnosis Related |
| W/MCC | Iingxaki eziMakhulu kunye neZigulo |
| W/CC | NgeeNgxaki kunye ne-Comorbidities |
| W/O CC/MCC | Ngaphandle kweengxaki okanye ii-Comorbidities, kwaye ngaphandle kweengxaki ezinkulu kunye ne-Comorbidities. |
| Ubunzima obunxulumeneyo | Ixabiso lamanani elibonisa ukusetyenziswa kobutyebi obunxulumeneyo kwi-DRG eyabelwe yona |
IMITHOMBO
- IShedyuli yoMrhumo kaGqirha weCMS. I-CMS-1784-F. https://www.cms.gov/medicare/medicare-fee-service payment/physicianfeesched/ puffs-federal-regulation-notices/cms-1784-f
- Intlawulo ye-CMS ASC. I-CMS-1786-FC ASC. https://www.cms.gov/medicare/payment/prospective-payment systems/ambulatory surgical-center-ask/ask-regulations-and/cms-1786-fc
- Intlawulo ye-CMS OPPS. I-CMS-1786-FC. https://www.cms.gov/medicare/payment/prospective-payment systems/hospitaloutpatient/regulations-notices/cms-1786-fc
- CMS, 2024 ICD-10 Inkqubo yeKhowudi System (ICD-10-PCS). https://www.cms.gov/medicare/coding billing/icd-10-codes/2024- icd-10-pcs
- I-CMS, 2024 ICD-10-CM/PCS MS-DRG v41, Incwadi yeeNkcazo. https://www.cms.gov/icd10m/FY2024 nprmversion41.0-fullcodecms/fullcode_cms/P0001.html
- CMS, [CMS-1785-F] 2024 Medicare Hospital Inpatient Prospective Payment System (IPPS) Final Rule; Irejista ye-Federal.
https://www.govinfo.gov/content/pkg/FR-2023-08-28/pdf/2023-16252.pdf. Intlawulo ibalwa ngokusekelwe kwixabiso lesizwe elilungelelanisiweyo elisemgangathweni $7,001.60. Iintlawulo ezichanekileyo zeMedicare ziya kwahluka kuhlengahlengiso lwe-Wage Index kunye neGeographic Adjustment Factor ngokuxhomekeke kwindawo yendawo. Kwakhona qaphela ukuba nayiphi na i-coinsurance esebenzayo, i-deductible, kunye nezinye iimali ezizibophelelo zesigulane zibandakanyiwe kwintlawulo yentlawulo ebonisiweyo. - Amaziko oLawulo lweSifo kunye noThintelo (CDC), iZiko leSizwe leNkcazo yezeMpilo (NCHS). Ulwahlulo lwamazwe ngamazwe lweZifo, uHlaziyo lweShumi, ukuguqulwa kweKlinikhi (ICD-10-CM). https://www.cdc.gov/nchs/icd/icd-10 cm.htm. Ihlaziywe nge-29 kaJuni ngo-2023.
ISILUMKO: Umthetho we-Federal (US) uthintela esi sixhobo ukuba sithengiswe okanye ngokomyalelo kagqirha. Ulwazi olubalulekileyo: Phambi kokusetyenziswa, jonga kwiMiyalelo yokuSetyenziswa enikezelwe nesi sixhobo ngemiqondiso, izithintelo, iziphumo ebezingalindelekanga, inkqubo ecetyiswayo, izilumkiso kunye nezilumkiso. IGalvanize kunye ne-Aliya ziimpawu zorhwebo kwaye zinokubhaliswa e-US kunye/okanye nakwamanye amazwe.
Onke Amalungelo Agciniwe.
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