Radiology Coding Alert

CMS heard your protests against TC denials on hospital admission days Good news: Medicare will start paying imaging services' technical component (TC) on admission days as long as you aren't coding for the hospital. CMS imposed an edit last April stating that Medicare wouldn't pay for radiology services' TC if they happened on the same date as a patient's hospital admission or discharge.
Learn From This Example A provider calling into the agency's Aug. 14 physician open-door forum said patients sometimes come into the office and receive x-rays. Then the doctor decides to admit the patient to the hospital the same day. Medicare will deny the TC payment for those x-rays because they're on the same day as the hospital admission. The edit causing these denials will disappear on Oct. 1, according to Transmittal 1295 (Change Request 5675, www.cms.hhs.gov/Transmittals/downloads/R1295CP.pdf). Medicare should pay for imaging services on the admission and discharge dates, as long as someone other than the hospital provides them. Action plan: If you've received denials based on this edit since April, you should "bring them to the attention of the contractor," one CMS official said. "An appeal is one way to do that."