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Reminder: Organ Procurement Code Conversion and Billing Instructions

Marchh 16, 2015

Effective for dates of service on or after April 1, 2015, the Department of Health Care Services (DHCS) will discontinue the use of current Medi-Cal codes for outpatient organ procurement services. The codes will be replaced by Current Procedural Terminology – 4th Edition (CPT-4) codes in combination with National Uniform Billing Committee (NUBC) revenue codes.

Organ procurement claims will:

  • Require an appropriate revenue code in Revenue Code field (Box 42)
  • Require an appropriate CPT-4 code for surgery procedure in the HCPCS/Rate field (Box 44)
  • May contain ICD-9-CM diagnosis codes V70.8 in the Diagnosis Code fields (Boxes 67 – 67Q)

Organ procurement claims submitted without both a CPT-4 code and revenue code will be denied.

These changes are as follows:

Current Billing New Billing
Interim Code Organ National Code/Description Revenue Code/Description
Z7304 Heart CPT-4 Code
33999
Cardiac surgery procedure
One Revenue Code Required:
810
Acquisition of body components general classification
811
Acquisition of body components living donor
812
Acquisition of body components cadaver donor
813
Acquisition of body components unknown donor
814
Acquisition of body components unsuccessful organ search
815
Reserved value
816
Reserved value
817
Reserved value
818
Reserved value
819
Acquisition of body components other donor
Z7306 Liver CPT-4 Code
47399
Liver surgery procedure
Same as above
Z7308 Kidney CPT-4 Code
53899
Urology surgery procedure
Same as above
Z7312 Heart-Lung CPT-4 Codes
32999
Chest surgery procedure
and
33999
Cardiac surgery procedure
Same as above
Z7314 Single lung CPT-4 Code
32999
Chest surgery procedure
Same as above
Z7316 Double lung CPT-4 Code
32999
Chest surgery procedure
Same as above
Z7320 Small bowel CPT-4 Code
44799
Unlisted procedure, intestine
Same as above
Z7322 Combined liver-small bowel CPT-4 Codes
44799
Unlisted procedure, intestine
and
47399
Liver surgery procedure
Same as above
48550 Pancreas CPT-4 Code
48999
Unlisted procedure, pancreas
Same as above
S2055 Simultaneous
kidney-pancreas
CPT-4 Codes
53899
Urology surgery procedure
and
48999
Unlisted procedure, pancreas
Same as above
Z7310 Fixed wing air transport/ professional harvest team HCPCS code
A0999
Unlisted ambulance service
Same as above

Also effective for dates of service on or after April 1, 2015, assistant surgeon services are not reimbursable in connection with outpatient organ procurement.