Medical Billing and Coding Healthcare Blog

The Centers for Medicare & Medicaid Services (CMS) has announced that coinsurance and deductible are not being waived on claims containing codes G0473 (intensive behavioral therapy for obesity) and 77063 (screening digital breast tomosynthesis, bilateral).

CMS notes the problem, a result of a systems error, will be corrected on April 6, 2015.

For claims with dates of service of January 1, 2015, through March 31, 2015, Medicare administrative contractors will be mass adjusting these claims and issuing corrected payments for all impacted claims.

CMS states providers must reimburse beneficiaries for any overpayment caused by this error.

The January/February 2015 issue of the American College of Radiology's (ACR) Radiology Coding Source is now available, and it discusses many topics that should be of interest to any organization that performs lab billing and coding.

The current issue, released late February, includes the following:

  • Answers provided by ACR to questions about Medicare requirements, standards and reimbursement terms for low-dose CT lung cancer screening
  • Analysis of the Centers for Medicare and Medicaid Services' decision to delete the NCCI edit for the code pair 77063/77052
  • Recommendations on how providers should submit claims for four code pairs code with both modifiers -GG and -59 to bypass NCCI edits
  • Discussion of the importance of imaging services appearing in the Office of Inspector General's 2015 Work Plan
  • Resources and links to help ensure radiology practices remain current and in compliance with coding and policy guidelines

To access the January/February 2015 issue of Radiology Coding Source, click here.