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The Centers for Medicare & Medicaid Services (CMS) has announced it discovered systems errors affecting claims with new drug testing laboratory codes (HCPCS codes G0477 through G0483) with dates of service on or after January 1, 2016.

If you are affected, CMS states that your Medicare Administrative Contractor (MAC) will be holding these claims until April 4, 2016. No provider action is required.

Should you wish to avoid your claims from being held, you can remove codes G0477 through G0483 and submit the rest of the services on the claim, CMS notes. When the system is updated in April, you can submit an adjustment claim to add these HCPCS codes. Your MAC will correct any claims previously returned to you in error with these codes and reason code W7006 after the system is updated.

The American Society of Clinical Oncology (ASCO) has published a free, downloadable resource that identifies oncology billing and coding updates for 2016.

Topics discussed include the following:

  • New CPT codes (99415 and 99416)
  • Radiation oncology CPT updates
  • New HCPCS codes (J8655, J7508 and J7503)
  • Deleted HCPCS codes
  • Filgrastim HCPCS updates
  • Chemotherapy drugs (replacements) HCPCS codes
  • ICD-10 update

To access the free resource, click here.

If your oncology practice needs assistance with its billing, contact PGM. For more than 30 years, PGM's team of certified coders and billing experts have managed all aspects of oncology billing to help ensure practices receive proper compensation for services provided.

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