Oncology & Hematology Coding Alert

Plus: A new ABN is in the works CMS is busy making changes that affect your reimbursement. Here's what you need to know.
1. Cheer New Covered Diagnosis for hCG Test CMS took a close look at the narrative describing conditions that make human chorionic gonadotropin (hCG) testing reasonable and necessary and decided 158.9 (Malignant neoplasm of retroperitoneum and peritoneum; peritoneum, unspecified) deserves to be on the covered codes list. Physicians use hCG testing to monitor and diagnose germ cell neoplasia (www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=200).
2. Burn That Pile of Old ABNs? CMS proposed a new version of the ABN form in the Feb. 23 Federal Register. The new form includes information about the beneficiary's right to demand that the provider bill Medicare for a service before paying out-of-pocket. And it now lets the patient choose among three options, instead of just two: 1. Don't provide the service 2. Provide the service and let the patient pay out-of-pocket 3. Provide the service and bill Medicare first. Clarification: Patients have always had the right to insist that you bill Medicare and receive a denial before billing them out-of-pocket, but the form didn't make this clear before, says Joan Adler with Adler Advisory Services in Atlanta.