2017 HCPCS CHANGES.....Urgent!!!!!!!!!!!!!! Please help...

CodingKing

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https://www.cms.gov/Medicare/Coding...=1&DLEntries=10&DLSort=0&DLSortDir=descending

In the Zip file look for the following files


1) HCPC17_CONTR_ANWEB.


Its a listing of all the HCPCS codes. You will want to filter by the last column which is the ACTION CD (action code).

Make sure yiu also filter by the column titled ACT EFF DT (3 columns from the end) as this file also includes any changes that happened in 2016 after the January 2016 file. Id probably review them anyways to make sure you didn't miss any updates after 1/1/16​


2) HCPCS2017_TransReport_Alpha file.
The key to what each letter means is on the third tab of the spreadsheet. I have also listed the action codes below as well

Action Codes

A - Add
B - Change in both Coverage & Long Description
C - Change in Long Description
D - Discontinued
F - Change in Coverage
N - No Change
P - Change in Payment
R - Re-activated
S - Change in Short Description
T - Miscellaneous change (BETOS or Type of Service)​
 
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NishaJ

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Thank you very much @ Coding king ...

I have a doubt whether G0477, G0478 & G0479 has deleted. Because in this below CMS CY2017-CLFS-Codes-Final-Determinations.pdf link , there is a final determination to delete G0477, G0478 & G0479 . whereas in the above link, these G codes still active....

Please anyone make me clear on this....
https://www.cms.gov/Medicare/Medica...ds/CY2017-CLFS-Codes-Final-Determinations.pdf


Thanks in advance for your valuable replies....
 

CodingKing

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My only guess is it wasn't decided on in time for the January 2017 update? Looking at the CMS RVU file the new 8xxxx codes are set to a status A but it doesn't list a rate. The G codes can be updated quarterly so I'm thinking maybe April and retroactive to 1/1/17. CMS loves to make retroactive changes.
 
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CodingKing

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Additional info come to light. we were just notified about the some of the G codes terming.



From what I’ve read so far of the document you posted.

Definitive drug screening (codes G0480-G0483) are going to be revalued and the description is going to be clarified since they are being misused. They are also going to create a new code (G0659) for laboratories that are running a less sophisticated version of the test.

Presumptive drug screen (codes G0477-G0479) are going to be mapped to the new drug screen codes 80305-80307 and then the G0477-G0479 will be termed as codes

The rest of the document is about unrelated lab codes.
 

NishaJ

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2017 HCPCS CHANGES.....Urgent!!!!!!!!!!!!!! Please help.

The above mentioned CMS link for hcpcs 2017, that is revised on 11/17/2016. Do we have any revised 2017 HCPCS list after this 11/17/2016...
 

mvmb2004

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Is Medicare / Medicaid accepting 8030_ instead of G047_? I cannot see anywhere that these codes will be accepted.
 

shruthi

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Still confused with G0477.

AAPC Coder shows that G0477 is deleted from 01/01/2017 but in Find-A-Code this is still active code. Am yet to receive my CPT book so not able to judge if this code is deleted or active.

Any suggestions on this.

Regards,
Shruthi
 

Nancy Klein

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Both G0477 and 80305 denied

Our office has tried billing Medicare both G0477 and 80503 and both have denied. Anyone know which one is correct for Medicare in 2017? :confused:
 
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Tricare g0479 and 80307

Can someone assist with what code to bill to Tricare for presumptive testing? G0479 is being rejected as an invalid code (due to out of date). Tricare is denying the 80307 as non-covered. The 80307 is on the no pay list.
 
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Have you confirmed your CLIA number is attached to the 80503 in your billing system?

Tricare has still not issued approval to pay for codes 80305 to 80307. It is expected that Tricare would issue approval in the month of April and after that denied claims can be refiled. We had the same issue for the cpt code G0477 last year.
The issue with medicare is the QW modifier. 80305 was not in the clia list issued in the month of January but in the month of April 80305 is added to the list hence denied claims can be submitted in the month of April with QW modifier.

Hope this helps.
 
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coder

I have a question in reference to CPT code 80307 denial for Cigna 3 units (exceeds number of days & units)? Have anyone ever received this before? Please help.
 
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