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G0297 low dose lung cancer screening

Pessie Posted Tue 20th of December, 2016 14:56:38 PM
Is G0297 a deleted code? when I click on the deleted code I get the following message: To Report, use:G0297. Deleted and yet to report use G0297? Doctor performed 71250, and got an authorization. However, the referring used G0297 in the request for authorization. Can we correct the claim with G0297 or not? Thank You
SuperCoder Answered Wed 21st of December, 2016 03:14:42 AM

Hi,

As per coding guidelines CPT code 71250 cannot be billed with G0297.

Beginning Jan. 4, 2016, Medicare contractors will accept claims for LDCT lung cancer screening retroactive to the Feb. 5, 2015, date of the NCD.

The following two new G codes should be used for the shared decision-making visit (G0296) and LDCT lung cancer screening (G0297). Note that Medicare will deny G0296 and G0297 for claims that do not contain ICD-9 code V15.82 (ICD-10 Z87.891, personal history of tobacco use/personal history of nicotine dependence).

Patient Eligibility/ Coverage by Medicare for LDCT lung cancer screening

Patients must:

Be age 55-77 years of age.

Have no signs or symptoms of lung cancer.

Have a 30-pack years or greater history of tobacco smoking.

<!-- -->Be current smokers or have quit smoking within the last 15 years, AND,

<!-- -->Have a written order for LDCT from a qualified health professional following a lung cancer screening counseling that attests to shared decision-making having taken place before their first screening CT.

Please check with your insurance provider regarding the authorization for billing CPT code 71250.

Thank You!

Pessie Posted Wed 21st of December, 2016 08:12:29 AM
G0297: don't see any ICDs listed for this code. I did see it among the deleted codes. and that was my question. is this an active or deleted code?
SuperCoder Answered Fri 23rd of December, 2016 02:29:02 AM

Hi,

Due to some technical glitch, it was showing as deleted code. The same has been rectified in SuperCoder.

For your information, G0297 is an Active code.

Sorry for the inconvenience caused.

Thank you!

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