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MIR-2006-11AB, November 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Termination of Healthcare Common Procedure Coding System (HCPCS) Code G0107, Colorectal Cancer Screening, Fecal-Occult Blood Tests (FOBT), 1-3 Simultaneous Determinations
Provider Types Affected
All providers who bill Medicare carriers or fiscal intermediaries (FIs), including Part A/B Medicare Administrative Contractors (A/B MACs) for Fecal Occult Blood Tests administered to Medicare beneficiaries
Provider Action Needed
Impact to You
Do not use HCPCS code G0107 for screening Fecal Occult Blood Tests (FOBT) on or after January 1, 2007. As of that date, that code is being deleted and replaced by CPT code 82270.
What You Need to Know
Effective January 1, 2007, HCPCS code G0107 for screening Fecal Occult Blood Tests (FOBT) is being terminated and replaced by CPT code 82270. If you use HCPCS code G0107 for FOBT on or after this date, your reimbursement could be impacted as the claim will be returned as unprocessable.
What You Need to Do
Make sure that your billing staffs are aware of this coding change for FOBT.
Background
HCPCS code G0107 will be retired at the next annual release of the clinical diagnostic laboratory fee schedule effective January 1, 2007, and replaced with current procedural terminology (CPT) code 82270.
Prior to January 1, 2007 use G0107 for billing Medicare for screening FOBT; however, on or after January 1, 2007 (the effective date of the 2007 clinical diagnostic lab fee schedule), use code 82270 for billing Medicare for screening FOBT.
Additional Information
The official instruction issued to you carrier, FI, or A/B MAC is CR 5292, located at http://www.cms.hhs.gov/Transmittals/downloads/R1062CP.pdf  on the CMS Web site. Revised Medicare Claims Processing Manual (Publication 100.04), Chapter 18 (Preventive and Screening Services), Section 60 (Colorectal Cancer Screening), Subsections 60.1-60.7 are included as an attachment to that CR.
If you have any questions, please contact your carrier, FI, or A/B MAC at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip  on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
MLN Matters Number: MM5292
Pub. 100-4, Transmittal# R1062CP, CR# 5292
Related CR Release Date: September 22, 2006
Effective Date: January 1, 2007
Implementation Date: January 2, 2007
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