Neurosurgery Coding Alert

Question: What are the revisions in HCPCS 2016 for CT machines? What are the fee cuts projected for machines that are not to mark?

Ohio Subscriber

Answer: Effective Jan. 1, 2016, certain CT services using machines that aren't up to snuff on dose optimization face a 5 percent fee cut from Medicare. The reduction applies only to the technical component (whether alone or part of the global) and only to services paid under the Medicare Physician Fee Schedule. The cut will increase to 15 percent in 2017.

To identify those CT services subject to the new rule, HCPCS 2016 adds 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).

Among the target codes facing reduction are 71250-71275 for CT of the thorax and CTA of the chest, and 75571-75574 for CT and CTA of the heart.

To see the complete list of codes affected, review Transmittal 3402, CR 9250, which updates the Medicare Claims Processing Manual (www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3402CP.pdf). For more on the standards involved, see www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Radiation Safety/XR29 FAQs_91015.pdf.