Results 1 to 5 of 5

S0353 Cancer Tx Plan Initial

  1. #1
    Spokane, WA
    Exclamation S0353 Cancer Tx Plan Initial
    Medical Coding Books
    I reviewed the NAS Part B Medicare email that was rec'd today. This included HCPCS quarterly update. I am a little confused...There were updates to S codes. Aren't S codes temporary codes for non-Medicare? If so, why would Medicare be sending this update? Has anyone heard anything about codes:

    S0353 Cancer Treatment Plan, Initial
    Treatment planning and care coordination management for cancer, initial treatment.

    S0354 Cancer Treatment Plan, Change
    Treatment planning and care coordination management for cancer, established patient with a change in regimen.

    This is a big deal if we can start charging for these. I haven't heard anything. Any thoughts? Anyone heard anything?

    Thanks, all!

  2. Default
    I believe these went into effect 4/1/12. Some commercial payers, like BCBS, are recognizing and paying for these codes. From everything I've seen, Medicare has no allowable for these services, nor are they on the carrier priced list for my state (Florida).

    I agree with you, getting codes for these previously unreimbursed services is a really big deal. It is definately a step in the right direction. Now we just need the payers to recognize and pay for the services we have been rendering.

  3. #3
    Columbia, MO
    HCPC II codes are created by CMS, you were getting the CMS quarterly update to the HCPC II codes via your Medicare provider, s codes are designated non medicare and are used primarily for Medicaid but on a rare occasion are accepted by other carriers.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default S0353/s0354
    What are the indications for reporting HCPCs codes S0353 or S0354 (BCBS, etc.)? There is a physician fee schedule for these codes from BCBS.
    Would you report these for Survivorship care plans or chemotherapy teaching/counseling provided by nurse practitioners?


  5. #5
    Columbus, Ohio
    Default S0353
    Currently in Ohio the only payer we have using those two S codes are Anthem BC/BS as part of their Quality Care program. They initiated this program maybe a couple of years ago? It boils down to whether or not a patient's on one of their pathways, if they are we're supposed to bill the S codes & be reimbursed for treatment planning, care coordination etc. Most of the time they're paid without incident, every once in awhile they'll deny one & we have to call & explain their own program to them! Good luck!
    Julie Brandt, CHONC

Similar Threads

  1. Plan of Care & Physician Plan of Treatment
    By lmfort in forum Neurology/Neurosurgery
    Replies: 0
    Last Post: 08-13-2015, 10:45 AM
  2. Initial Plan of Care service code
    By msonger in forum Behavioral Health
    Replies: 0
    Last Post: 09-18-2013, 11:04 AM
  3. Psychiatric Treatment Plan/Recovery Plan/Care of Plan
    By rnakahara in forum Employment General Discussion
    Replies: 1
    Last Post: 07-17-2009, 03:00 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.