Part B Insider (Multispecialty) Coding Alert

Reader Question:

Blink And You'll Have Missed Specialty Code 95

Question: Can you clarify under which circumstances we'll need to use specialty code 95 for ADI?

Answer: Specialty code 95 will not be available for use to indicate advanced diagnostic imaging (ADI) accreditation.

History: In April 2011, CMS issued Transmittal 2192, indicating a new specialty code 95 would apply to ADI accreditation.

But on June 24, CMS issued Transmittal 2248 (www.cms.gov/transmittals/downloads/R2248CP.pdf) eliminating the use of 95 for ADI. Instead, 95 will be defined as "open." As a result, the Provider Enrollment, Chain, and Ownership System (PECOS) will not recognize specialty code 95.

Caution: The specialty code rule may have changed, but one thing remains the same. To furnish the technical component of ADI services for Medicare beneficiaries, you must be accredited by Jan. 1, 2012. CMS still will be able to verify that you're ADI-accredited via information sent by the three recognized accrediting organizations.

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