Health Information Management

Healthcare News: CMS updates list of codes not requiring modifier -Q0

JustCoding News: Outpatient, April 7, 2010

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CMS recently updated the list of ICD-9-CM diagnosis codes that don’t require HCPCS modifier -Q0 for implantable cardiac defibrillator services provided in a clinical study. 

Billing staff members should be aware that ICD-9-CM diagnosis code V12.53 (Sudden cardiac arrest) does not require modifier -Q0 (Investigational clinical service provided in a clinical research study that is in an approved clinical research study) for payment, according to Transmittal 663 in the One-Time Notification Manual, which CMS issued March 26.

Note the following complete list of diagnosis codes that do not require a -Q0 modifier:

  • 427.1 (Ventricular tachycardia)
  • 427.41 (Ventricular fibrillation)
  • 427.42 (Ventricular flutter)
  • 427.5 (Cardiac arrest)
  • 427.9 (Cardiac dysrhythmia, unspecified)
  • V12.53 (Sudden cardiac arrest)
  • 996.04 (Mechanical complication of cardiac device, implant, and graft, due to automatic implantable cardiac defibrillator)
  • V53.32 (Fitting and adjustment of other device, automatic implantable cardiac defibrillator)

To learn more, access Transmittal 663 and MedLearn Matters article 6867.

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