Part B Insider (Multispecialty) Coding Alert

Physician Notes:

CMS Hasn't Established Lung Cancer Screening Code Yet

Published on Fri Apr 17, 2015

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Plus: Don’t forget the legible signature rule.

If you’re interested in billing Medicare for a patient’s lung cancer screening, you may not have a code just yet—but CMS aims to change that soon, said CMS’s Jamie Hermanson during an April 14 CMS Open Door Forum.

When a caller to the forum asked which HCPCS or CPT® code she should report for the service, Hermanson responded that the code will be forthcoming. “We know that this has been something we have heard a couple of times. We are in the process of working on the implementation pieces of this policy and part of that is working on the coding guidance for this particular service,” Hermanson said. “At this point I don’t have any additional information for you, but we do want to assure you we are working on it and are doing our best to get that information out to you as soon as possible.” CMS will be releasing a MLN Matters article and a change request as soon as the information is available, she added.

To qualify for the annual screening, Medicare patients must meet the criteria below:

Age 55 to 77
Showing no signs or symptoms of lung cancer
Either current smokers or quit within the past 15 years
Tobacco smoking history of at least one pack a day for 30 years
They have a written order from their provider

Resource: To read the complete CMS Decision Memo outlining the requirements for LDCT screening, visit www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274.

In other news…

If your claims are lacking a legible signature, you’ll also find a lack of income. That’s because CMS requires a legible signature on your documentation, said Part B MAC NGS Medicare in a recent reminder.

“Unsigned documentation or lack of attestation will result in the denial of services,” the payer says. “The MD signature is required on orders for laboratory services, diagnostic and therapeutic procedures, therapy treatment plans and physician progress notes,” NGS adds.

What about chicken scratch? If your doctor’s signature is present but unreadable, you’ve got options, NGS says. “If you notice the signature is illegible when asked to supply medical records, please include a signature key, signature page or a document from the provider/physician or compliance officer that affirms the signature is indeed the provider’s/physician’s.”

Resource: To read more about how to comply with Medicare’s signature requirements, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Signature_Requirements_Fact_Sheet_ICN905364.pdf.