In an MLN Matters article published late last year, the Centers for Medicare & Medicaid Services (CMS) discussed the creation of modifier -CT (computed tomography services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association (NEMA) XR-29-2013 standard).
Effective for claims submitted on or after January 1, 2016, CMS now requires the use of -CT for applicable CT scans furnished on non-NEMA Standard XR-29-2013-compliant equipment. Providers must append it to codes for CT scans on services furnished on equipment that do not adhere to this NEMA standard.
The codes are as follows:
- Successor codes
According to the American College of Radiology (ACR), CT scanners meeting the XR-29 standard have the following:
- DICOM-compliant radiation dose structured reporting
- Dose check features
- Automatic exposure control
- Reference adult and pediatric protocols
As CMS notes, a payment reduction of 5% will apply to CT services furnished using equipment that is inconsistent with the CT equipment standard and for which payment is made under the physician fee schedule. The payment reduction increases to 15% in 2017 and subsequent years.
For more information on modifier -CT, see the following:
- Association for Quality Imaging report
- AAPC report
- Society of Nuclear Medicine and Molecular Imaging report