Radiology Coding Alert

Question: When should I start using the new NOPR modifiers Q0 and Q1?

Maryland Subscriber

Answer: CMS instructed local contractors to accept these modifiers no later than April 7. Check with your local contractor, however, because some may start accepting them sooner.

Background: HCPCS 2008 introduced modifiers Q0 (Investigational clinical service provided in a clinical research study) and Q1 (Routine clinical service provided in a clinical research study that is in an approved clinical research study). Note that Q0 is Q "zero."

You should use these modifiers to identify investigational and routine clinical services in a Medicare-approved clinical research study, according to CMS Transmittal R1418CP, CR 5805 (http://www.cms.hhs.gov/transmittals/downloads/R1418CP.pdf).

Once your contractor implements the change, you should use Q0 rather than QR (Item or service provided in a Medicare specified study) or QA (FDA investigational device exemption), and Q1 rather than QV (Item or service provided as routine care in a Medicare qualifying clinical trial).

You need to apply these modifiers when you report to the National Oncologic PET Registry (NOPR, http://www.cancerpetregistry.org), which allows participating providers to receive Medicare reimbursement for cancer imaging that Medicare typically doesn't cover.