New Billing Instructions for Colorectal Screening Services
- By admin aapc
- In Billing
- April 30, 2010
- Comments Off on New Billing Instructions for Colorectal Screening Services
Billing instructions for colorectal screening services will soon change. The new billing instructions apply to screening services provided to hospital inpatients submitted under Medicare Part B or when Part A benefits have been exhausted.
Effective Oct. 1, 2010, providers should report 12X TOB instead of 13X TOB when submitting claims for screening colorectal services to fiscal intermediaries (FIs). This applies to the following CPT® and HCPCS Level II codes:
82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)
G0104 Colorectal cancer screening; flexible sigmoidoscopy
G0105 Colorectal cancer screening; colonoscopy on individual at high risk
G0106 Colorectal cancer screening; alternative to G0104, screening sigmoidoscopy, barium enema
G0120 Colorectal cancer screening; alternative to G0105, screening colonoscopy, barium enema
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous determinations
The Centers for Medicare & Medicaid Services (CMS) Transmittal 1953, Change Request (CR) 6760, issued April 28 notifies fiscal intermediaries (FIs) of this change to billing instructions in Pub. 100-04, chapter 18, section 60, subsection 60.6 of the Medicare Claims Processing Manual.
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Can some explain this ariticle in more detail for me?
What is a 12xTOB?
This artical explains this issue in more detail: http://www.asktheadministrator.com/content/view/30/119/
I’m just trying to figure out how to implement it properly. : (
12x TOB is Hospital Inpatient (Medicare Part B Only) –
Use this TOB to bill for covered ancillary services when the patient has Part B entitlement
only or when Part A benefits are not payable or are exhausted. HCPCS codes may not be
not required on a 012X claim, nor should the claim contain charges for inpatient
accommodations. Outpatient services rendered prior to this admission should be
submitted on an outpatient bill with TOB 013X.