Cardiology Question for the Week of March 27, 2017

Question:

It has been my understanding that a facility could report the Q0 modifier when billing for placement of an implantable cardio-defibrillator (ICD) system, but that it is not required to submit the claim to a registry. This was primarily for Medicare to track these claims. Is this correct? We have begun to receive denials.

Answer:

When billing for insertion of an ICD for primary prevention, you must submit your claims to the American College of Cardiology’s National Cardiovascular Data Registry and bill using the Q0 modifier (https://www.ncdr.com/webncdr/home/aboutthencdr).

If you are inserting the ICD for secondary prevention, you do not have to submit to the registry, but if you do, you must bill using the Q0 modifier. Hospitals are encouraged to report all (primary and secondary) ICD implants to the registry.

Additional information may be found at https://www.cms.gov/Medicare/Medicare-General-Information/MedicareApprovedFacilitie/ICDregistry.html

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