Oncology & Hematology Coding Alert

Question: I heard that the switch to combined Part A/Part B Medicare contractors will make proper reporting of technical and professional services even more important. Is this true?


North Dakota Subscriber


You heard correctly--a regional contractor will be able to compare office and hospital services more easily.

Example: You code for a physician who participates in block design. You report 77333 (Treatment devices, design, and construction; intermediate [multiple blocks, stents, bite blocks, special bolus]) and append 26 (Professional component).

If the facility reports the technical component of block creation with 77332 (... simple [simple block, simple bolus]), the contractor will be able to catch the discrepancy, which could lead to denials.

Good news: Having a single office handle all claims for a region should boost efficiency. 

The first combined Part A/Part B Medicare contractor will start July 2007, covering Arizona, Montana, North Dakota, South Dakota, Wyoming, and Utah, CMS officials told the June 27 Physician Open-Door Forum. CMS named Noridian Administrative Services the contractor for this region.

Read more at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0642.pdf. Stay tuned for updates.