In Coding
Mar 3rd, 2014
The Centers for Medicare & Medicaid Services (CMS) has removed the coverage of evidence (CED) requirement in the national coverage determination (NCD) for fluorodeoxyglucose (FDG) positron emission tomography (PET) for solid tumors, effective June 11, 2013. CMS will cover three FDG PET scans (without the CED requirement) when used to guide subsequent management of anti-tumor ...
In Billing
Jun 1st, 2012
The July update of the Ambulatory Surgical Center Payment System (ASC PS) implements several changes to Medicare billing instructions of which ASC coding and billing staff should be aware. The update includes new Category III codes, new instructions for device pass-through category C1840, and billing changes for medication. Billing staff, in particular, should take note ...
In CMS
Oct 29th, 2010
Effective for service dates on or after Dec. 15, HCPCS Level II code J3490 Unclassified drugs will be non-covered as a self-administered drug when used to bill Medicare Part B for Hizentra™ (Immune Globulin Subcutaneous (Human) (IGSC)). This is in accordance with the recently updated Self-Administered Drug Exclusions List, TrailBlazer Health Enterprises announced Oct. 22 in a notice ...
In Coding
Oct 1st, 2010
Quarterly updates to the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment System (ASC PS) for separately paid drugs and biologicals, covered surgical procedures, and ancillary services have been released to Medicare contractors. The updates include one newly created pass-through device HCPCS Level II code, five newly created drug HCPCS Level II codes, and six ...
In CMS
Apr 5th, 2010
The Centers for Medicare & Medicaid Services (CMS) recently revised National Coverage Determination (NCD) 220.6 – Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer. Effective Feb. 26, CMS will cover NaF-18 positron emission tomography (PET) imaging when the Medicare beneficiary’s treating physician determines that it is needed to inform the initial antitumor trea...