Health Information Management

Healthcare News: CMS transmittal outlines additional HCPCS codes subject to CLIA edits

JustCoding News: Outpatient, June 30, 2010

Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Outpatient!

On June 18, CMS issued Transmittal 720 in the One-Time Notification Manual, which lists new HCPCS laboratory codes for 2010. The codes are subject to edits to ensure that providers reporting the services have an appropriate Clinical Laboratory Improvement Amendments (CLIA) certificate prior to receiving payment. CMS added the following G codes:

  • G0416, G0416-TC, G0416-26 (surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 1–20 specimens)
  • G0417, G0417-TC, G0417-26 (surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 21–40 specimens)
  • G0418, G0418-TC, G0418-26 (surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, 41–60 specimens)
  • G0419, G0149-TC, G0419-26 (surgical pathology, gross and microscopic examination for prostate needle saturation biopsy sampling, greater than 60 specimens)

Facilities reporting these codes must have either a CLIA certificate of registration, a CLIA certificate of compliance, or a CLIA certificate of accreditation to receive payment.



Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Outpatient!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular