Radiology Coding Alert

No need to look for history of adverse reaction in non-hospital patients

Coding LOCM for Medicare just got a little easier. Effective Jan. 1, 2005, and implemented Oct. 31, 2005, CMS eliminated the five restrictive criteria for paying you for LOCM used with non-hospital patients.

Translation: As long as you have medical necessity for an imaging procedure (intra-arterial or intravenous) using LOCM, expect payment for the contrast if your payer adopts these new Medicare guidelines.

You no longer have to prove a history of adverse reaction, history of asthma or allergy, cardiac dysfunction, severe debilitation, or sickle-cell disease.

Remember: You should have been reporting LOCM with new codes Q9945-Q9951 (rather than older codes A4644-A4646) since April 4, 2005, for most Medicare services (www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3748.pdf).

You'll find the official instruction (CR3902) regarding the end on LOCM restrictions at www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp.