Advocacy

ASNC Policy & Advocacy Initiatives
 
Through the support of its members, ASNC’s legislative advocacy efforts have brought the concerns and issues of the field of nuclear cardiology to government agencies and to Congress. It takes a Society and its members to make a difference. Your membership is critical to being heard in Washington. Help ASNC advocate on behalf of nuclear cardiology professionals and their patients — join or renew your ASNC membership today!
 
Coding Alert: 
ASNC Identifies Incorrect NCCI Edits, Pursuing Remedy

 

 
ASNC has learned that there are more than a dozen incorrect edits in the National Correct Coding Initiative (NCCI) pertaining to new and revised CPT codes that went into effect January 1, 2020. Please share this information with your coding team.
The Centers for Medicare & Medicaid Services (CMS) deleted the following procedure-to-procedure (PTP) edits: 
Other identified errors for Nuclear Cardiology include -- 
  • CPT 78429 Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries edit is a 1. We disagree and have requested the removal of edit common tracer for this procedure.
     
  • CPT 78430 edit with A9555 Rubidium-82, diagnostic, per study dose, up to 60 millicuries edit is a 1. We disagree and have requested the removal of edit common tracer for this procedure, common perfusion tracer. 
New below -- 
  • Cardiac PET (CPT 78492) with the A9555 for rubidium. Now, just the 78492 is being denied M20 missing/incomplete/invalid HCPCS. We called CMS and were told to add A9597 or A9598 code, which indicates tumor or no tumor; this is wrong as those are oncologic. 
 
Next Steps

ASNC is in discussions with both CMS and the American Medical Association about the NCCI edit errors. For now, we recommend the following:
  • Continue billing as usual.
     
  • Be aware that the line item radiopharmaceutical may deny payment, but you must continue to bill for the radiopharmaceutical so that when the edit is corrected providers can be appropriately reimbursed.
     
  • You may choose to appeal the denial of the radiopharmaceutical. You may share this communication with your Medicare Administrative Contractor (MAC) so the MAC understands that an incorrect NCCI edit has been identified. The MAC is required to pay on any edit until it is identified by CMS as an error. They may ask for the claim to be appealed or issue a mass adjustment. Any mass adjustment would be made after the NCCI accepts and approves the errors. At this point, ASNC is unsure how all these edits will be handled. 
To report an issue with a code pair, email glawrence@asnc.org.

Advocacy Efforts in Washington:
Our Health Policy and Regulatory Affairs staff and committee are working hard to support the advancement of the field of nuclear cardiology. By meeting with key legislative offices, responding to legislation with Action Alerts, working hand-in-hand with membership on regulatory issues, and collaborating with other societies on advocacy initiatives,

We are working for you — in Washington and in other critical areas, including education, research, quality, and guidelines and standards. ​ASNC has addressed such issues as patient access to diagnostic imaging services, Medicare reimbursement, health care reform, medical isotope supply, and coding.
 
Learn more about our policy and advocacy efforts and find out about important legislative and regulatory issues in nuclear cardiology. Be sure to contact your legislators about policies and legislation directly impacting cardiovascular imaging.