Oncology & Hematology Coding Alert

Question: I've been expecting to see more information about CMS's place of service (POS) rule with an October 1 implementation date. Have there been any updates?

North Carolina Subscriber

Answer: CMS has delayed implementation for the POS rule you reference. The new effective/implementation date is April 1, 2013. CMS also added some revisions and clarifications to the rule regarding global diagnostic services, determining payment locality, and inpatient and outpatient services.

For instance: When reporting global 71010 (Radiologic examination, chest; single view, frontal), meaning without modifier 26 (Professional component) or TC (Technical component), the claim should reflect the ZIP code of the testing facility that performed the X-ray. And you may report the global code (without a modifier) only when the same physician/supplier performs both the TC and PC, and the TC and PC are furnished in the same fee schedule locality.

To review the revised MLN Matters article on this topic, head to www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7631.pdf.