Part B Insider (Multispecialty) Coding Alert

Published on Sun May 07, 2006 PDF

The Centers for Medicare & Medicaid Services finally issued instructions on how to enroll in the Competitive Acquisition Program for Part B drugs, which promised to take the headache of stocking and billing for drugs out of your hands.

In Transmittal 932, dated April 28, the agency says you can enroll by going to www.cms.hhs.gov/CompetitiveAcquisitionBios/02_infophys.asp and downloading the application. You can submit the form to your carrier.

"I think CMS is just going through the formality" of setting up the CAP program, because the agency knows providers aren't interested, says Carolyn Davis Hutt, reimbursement coordinator with Oncology Hematology West in Omaha, NE. "I have never felt that this was going to work."

In other transmittals, CMS also:

• Clarified the process of applying for a provider number and having your information checked by the carrier, in April 28 Transmittal 146.

• Allowed you to report diagnosis code V06.6 instead of both V03.82 and V04.81 if your patient received both the pneumococcal pneumonia and influenza vaccines, in April 28 Transmittal 921. It also required the carriers to accept CPT code 90660 for the flu vaccine.

• Introduced two new HCPCS codes for radiopharmaceutical diagnostic agents for PET scans in Transmittal 923, dated April 28. Code A9555 replaces Q3000 and A9552 replaces C1775.