April 01, 2022

New outpatient procedure grouper mapping exhibits for 2022

Effective July 1, 2022, we’re updating the outpatient procedure grouper (OPG) mapping exhibits to reflect the codes that are eligible for reimbursement for outpatient procedures and other services.

What this means for you
To help ensure accurate reimbursement, please use the correct CPT® and Healthcare Common Procedure Coding System (HCPCS) codes with revenue codes when submitting claims.

What’s changing in the OPG exhibits for 2022
In relation to 2021 OPG mapping, 99.3% of codes continue to be assigned to the same grouper level, while 0% have increased and 0.1% have decreased assigned levels.

To view the reimbursable codes, visit > View Outpatient Procedure Grouper Exhibits.

Contact your network management representative.