American College of Radiology, nuclear medicine society urge CMS to fix years-old billing code mistakes
Two imaging groups are urging the Centers for Medicare & Medicaid Services to fix years-old coding errors that could be impacting patient care.
The Society of Nuclear Medicine & Molecular Imaging and American College of Radiology said the mistakes date to 2020, when the agency revised certain codes. The issue relates to both single-photon emission computed tomography and SPECT/CT, according to a Tuesday, June 6 news update.
ACR and SNMMI highlighted concerns about codes for procedures that are typically performed on the same day, such as radiopharmaceutical therapy by IV administration and SPECT.
“Until these retroactive changes are made, patients are not only inconvenienced but also at risk as the new guidance requires the performance of separate procedures on separate dates of service,” SNMMI noted.
The two medical groups sent a joint letter urging CMS to make modifications back in March, and SNMMI had already sent several more requesting the code changes. The agency recently responded to clarify some of the procedure-to-procedure edits, and it made several updates, slated to go into effect for claims with July 1 or later dates of service.
SNMMI and ACR are pushing the agency to make any updates retroactive, so that radiologists and nuclear medicine specialists can still claim lost revenues impacted by the changes dating back to 2020.
“Providers should keep a listing of these claims and talk to their local Medicare contractor or payer to request manual payments,” SNMMI advised.
Read more about the issue from the society, including a list of all impacted CPT codes and procedures, here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.