Cardiology Coding Alert

Question: Should I report the LOCM Q codes for exams performed in a hospital setting?

Indiana Subscriber

Answer: If you're coding for the cardiologist ...quot; not the hospital ...quot; you shouldn't report low osmolar contrast material (LOCM) codes Q9945-Q9951, because the hospital provides the contrast.
 
If you code for the hospital, you should charge for the contrast. For an outpatient, you should report the proper Q code to receive the APC payment associated with the contrast (such as Q9945, Low osmolar contrast material, up to 149 mg/ml iodine concentration, per ml).
 
For an inpatient, you can charge for the contrast, even though HCPCS Q codes won't appear on the inpatient UB-92.
 
Check your codes: As of Jan. 1, 2006, you should be reporting LOCM Q codes instead of A4644-A4646 for both physicians and outpatient hospital services. You can find all the details in CMS Transmittal 804, Change Request 4250 online at www.cms.hhs.gov/HospitalOutpatientPPS/Downloads/R804CP.pdf.
 
Of course some payers are slow to change which codes they accept, so as always, check with your particular payer to determine which LOCM codes to report.