CMS Clarifies Coding Instructions for Lung Cancer Screening of Current Smokers

In response to comments by the American College of Radiology (ACR) and others, the Centers for Medicare & Medicaid Services (CMS) has modified its coding policies for low-dose CT lung cancer screenings of current smokers. CMS set a July 5, 2016, implementation date for the addition of ICD-10 F17.2 (nicotine dependence) codes to the Medicare National Coverage Determination (NCD) 210.14 list of approved codes for low-dose computed tomography (LDCT) lung cancer screening.  In addition, the CMS Coverage and Analysis Group provided a specific clarification after learning from the ACR that some claims for completed screenings will have been held too long by providers to meet designated filing deadlines, if a July 5 implementation date is adopted. Although a history of smoking is not considered the best code choice for current smokers, CMS advises providers to follow existing instructions contained in Change Request #9246 (Transmittal 1 and Transmittal 2) and to include ICD-10 Z87.891 on LDCT claims to ensure proper payment until the July 1 effective date.  The ACR was assured all claims processed according to current CR#9246 business requirements and meeting the NCD coverage criteria, which includes both present and past smokers, will be covered. CMS encourages providers to contact their local Medicare Administrative Contractor (MAC) with questions about claims and billing. An interactive map is available on the CMS website to he...
Source: American College of Radiology - Category: Radiology Source Type: news