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Medicare Monthly Review Part A and B
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National
Government Services, Inc. Medicare Monthly Review Part A and B |
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A
Combined Part A and Part B Newsletter |
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MLN Matters. . .Information for Medicare Providers |
Clinical Lab: New Automated Test for the Automated Multi-Channel Chemistry Code (AMCC) Panel Payment Algorithm
MLN Matters Number: MM5874
Related Change Request (CR) #: 5874
Related CR Release Date: February 15, 2008
Effective Date: July 1, 2008
Related CR Transmittal #: R83BP
Implementation Date: July 7, 2008
Provider Action needed
Impact to You
The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 5874 to alert providers that existing current procedural terminology (CPT) code 82330, Calcium; ionized is being paid as in individual test and was not included in the AMCC Panel Payment Algorithm. That changes effective July 1, 2008.
What You Need to Know
Effective July 1, 2008, CPT 82330 will become an automated chemistry test within the AMCC Panel Payment Algorithm for payment purposes.
What You Need to Do
Make certain your office staffs are aware of this change.
Background
Effective January 1, 2008, the CPT Editorial Panel created a new code 80047 Basic metabolic panel (Calcium, ionized) which is an automated multi-channel chemistry (AMCC) code and is currently included in the automated multi-channel chemistry code (AMCC) Panel Payment Algorithm. The new code 80047 is comprised of eight component test codes (see table below). Also, new code 80047 is not a replacement for code 80048 Basic metabolic panel. Both codes 80048 and 80047 are included in the 2008 clinical laboratory fee schedule.
Key Points
For ESRD dialysis patients, CPT code 82330 Calcium; ionized will be included in the calculation for the 50/50 rule (Pub 100-04, Chapter 16, Section 40.6). When CPT code 82330 is billed as a substitute for CPT code 82310, Calcium; total, it should be billed with modifier CD or CE. When CPT code 82330 is billed in addition to CPT 82310, it should be billed with CF modifier.
Note that, in accordance with the Medicare Claims Processing Manual, section 40.6.1, the new panel code 80047 cannot be billed for services ordered through an ESRD facility. All tests billed for services ordered through an ESRD facility must be billed individually, not in an organ disease panel. The Medicare Claims Processing Manual is available at http://www.cms.hhs.gov/Manuals/IOM/list.asp
on the CMS Web site.
Additional Information
To see the official instruction (CR5874) issued to your Medicare carrier, FI, or A/B MAC, refer to http://www.cms.hhs.gov/Transmittals/downloads/R83BP.pdf
on the CMS Web site.
If you have questions, please contact your Medicare 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. CPT only copyright 2007 American Medical Association.