CMS Reassigns HCPCS Code Q1003 to a Deleted Payment Indicator: Q&A With Cristina Bentin of Coding Compliance Management

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Cristina Bentin, CCS-P, CPC-H, CMA, is president of Coding Compliance Management.


Q: Since April 1, our clearinghouse has been rejecting claims with NTIOL Q1003. We understand that no additional reimbursement was to be received after the expiration date of Feb. 26, 2011, but there was no further direction as to reporting/dropping the Q code to a claim for tracking purposes. Are there new directives?


Cristina Bentin: Yes. According to Medicare Learning Network (MLN) #MM7343: "HCPCS Code Q1003 has been deleted effective April 1, 2011. HCPCS code Q1003 (New technology intraocular lens category 3 (reduced spherical aberration)) will no longer be reportable under the ASC payment system. ASCs were instructed to report HCPCS code Q1003 to bill for a Category 3 NTIOL associated with reduced spherical aberration from February 27, 2006, through February 26, 2011. As stated in the January 2011 ASC Update (Transmittal 2128, Change Request 7275, dated December 29, 2010), because this NTIOL category expired February 26, 2011, CMS assigned HCPCS code Q1003 to a packaged code indicator (PI= N1) for dates of service beginning February 27, 2011. Since HCPCS code Q1003 will be deleted, HCPCS code Q1003 will now be reassigned from a packaged code indicator (PI=N1) to a deleted payment indicator (PI=D5) effective April 1, 2011." (www.cms.gov/MLNMattersArticles/downloads/MM7343.pdf)

 

To contact Cristina Bentin (cristina@ccmpro.com) and learn more about Coding Compliance Management, visit www.ccmpro.com.


The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

 

Read more from Cristina Bentin:


- RAC Demand Letters: Surgery Centers Fight Back

 

- 2011 Coding Changes to Nervous System

 

- 2011 Coding Changes to Eye and Ocular Adnexa

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