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AAO-HNS Comments on CY 2021 HOPPS Final Rule

AAO-HNS Comments on CY 2021 HOPPS Final Rule

On January 4 the AAO-HNS submitted a comment letter to the Centers for Medicare and Medicare Services on the Calendar Year 2021 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (HOPPS) final rule. In response to AAO-HNS advocacy and stakeholder comments received, CMS amended the assignment of CPT code 69705 for eustachian tube balloon dilation for unilateral procedures, from ambulatory payment classification (APC) 5164 (Level 4 ENT Procedures) to APC 5165 (Level 5 ENT Procedures). For 2021, CPT codes 69705 (Nasopharyngoscopy, surgical, with dilation of the eustachian tube (i.e., balloon dilation); unilateral) and 69706 (Nasopharyngoscopy, surgical, with dilation of the eustachian tube (i.e., balloon dilation); bilateral) each map to APC 5165. Additionally, the Academy urged CMS to revise its decision and reclassify HCPCS code C9771 for nasal/sinus endoscopy, cryoablation nasal tissue(s) and/or nerve(s), unilateral or bilateral, utilizing the ClariFix device, to a higher APC. The rule took effect on January 1.

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