Transmittals and MLN Matters articles: CMS instructs on cardiac defibrillator services, affirms PET coverage policy, and more
Medicare Weekly Update, March 30, 2010
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CMS instructs on HCPCS codes not requiring Q0 modifier
On March 26, CMS issued a transmittal to update the list of ICD-9-CM diagnosis codes not requiring the Q0 HCPCS modifier for implantable cardiac defibrillator services provided in a clinical study.
Effective date: October 1, 2007, for ICD-9-CM V12.53
Implementation date: July 6, 2010
View the transmittal.
CMS affirms coverage policy for NaF-18 PET imaging to identify bone metastasis of cancer
On March 26, CMS issued two transmittals to affirm that evidence is not sufficient to determine that the results of NaF-18 PET imaging to identify bone metastases improve health outcomes of beneficiaries with cancer. Therefore, NaF-18 PET oncologic claims to inform of initial treatment strategy or subsequent treatment strategy for suspected or biopsy proven bone metastasis are covered only in the context of a clinical study. All other claims for NaF-18 PET oncology claims remain non-covered.
Effective date: February 26, 2010
Implementation date: July 6, 2010
View the Claims Processing Manual transmittal.
View the National Coverage Determinations Manual transmittal.
CMS replaces transmittals
CMS rescinded and replaced several transmittals previously outlined in Medicare Weekly Update.
- Screening for the Human Immunodeficiency Virus (HIV) Infection (R118NCD)
- Screening for the Human Immunodeficiency Virus (HIV) Infection (R1935CP)
- Validating the Billing of End Stage Renal Disease (ESRD) 50/50 Rule Modifier
MLN Matters articles
CMS released several MLN Matters articles related to transmittal previously outlined in Medicare Weekly Update.
- Clinical Laboratory Fee Schedule (CLFS) - Special Instructions for Specific Test Codes (CPT Code 80100, CPT Code 80101, CPT Code 80101QW, G0430, G0430QW, and G0431QW)
- Outpatient Intravenous Insulin Treatment (Therapy)
- Clinical Laboratory Fee Schedule (CLFS) - Medicare Travel Allowance Fees for Collection of Specimens
- Billing and Processing Claims with Unlimited Occurrence Span Codes (OSCs)
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