Radiology Coding Alert

Question: I've 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

Answer: You heard correctly--a regional contractor will be able to compare office and hospital services more easily than your current carriers.

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 its component of block creation with 77332 (... simple [simple block, simple bolus]) and appends TC (Technical component), 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 take effect July 2007, covering Arizona, Montana, North Dakota, South Dakota, Wyoming, and Utah, CMS officials told the June 27 Physician Open-Door Forum. CMS awarded Noridian the first contract. Read more at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0642.pdf. And stay tuned for updates.