For CY 2014, CMS proposes to define seven new categories of ancillary or supportive “dependent” items and services for which payment will be packaged into payment for the primary diagnostic or therapeutic service. The proposed new categories of packaged services are:

  1. Drugs, biologicals, and radiopharmaceuticals that function as supplies in a diagnostic test or procedure (except when pass-through status applies);
  2. Drugs and biologicals that function as supplies or devices in a surgical procedure (e.g., skin substitutes);
  3. Clinical diagnostic laboratory tests provided on the same date of service as the primary service and ordered by the same practitioner who ordered the primary service (excluding molecular pathology lab tests);
  4. Procedures described by add-on codes;
  5. Ancillary services currently assigned status indicator “X” (excluding preventive services currently assigned status indicator “X”);
  6. Diagnostic tests on the bypass list; and
  7. Device removal procedures that are billed with other surgical procedures involving device repair or replacement.

In addition to the proposed increased packaging of imaging services that are included as ancillary services with status indicator “X” or as diagnostic tests on the bypass list (categories 5 and 6, above), CMS is soliciting comments on a potential CY 2015 proposal to package all imaging services associated with surgical procedures.