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Coding updates, effective Jan. 1, 2018

01/30/2018

We will follow new policies of the Centers for Medicare & Medicaid Services (CMS) on the modifier "FY" reduction and changes to Medicare coding for mammography:

  • Starting Jan. 1, 2018, CMS requires hospitals and supplies to use the new modifier "FY" reduction for claims related to X-ray services taken using computed radiography technology/cassette-based imaging. This affects any radiology codes and reduces by 7 percent the allowable technical component fee or technical component of the global fee starting Jan. 1, 2018. The modifier will then further reduce the allowable fee by 10 percent after Jan. 1, 2023.

    This reduction applies to our Medicare claims only. For more information about this modifier reduction, refer to the CMS' guidance.

  • Under the 2018 Medicare coding for mammography, CMS has deemed HCPCS codes G0202, G0204 and G0206 obsolete for dates of service after Dec. 31, 2017. For dates of service beginning Jan. 1, 2018, CPT codes 77065, 77066 and 77067 are payable. As a reference, here’s the following crosswalk for these CPT codes:
    • G0206 to 77065
    • G0204 to 77066