Postponed CMS Proposal Would Remove Unspecified Cancer Dx Codes, Impacting Test Access

Just two months after proposing the deletion of unspecified cancer diagnosis codes, the Centers for Medicare and Medicaid Services postponed implementation of the policy for a year after stakeholders noted the potential disruptions to care and test access.

In a policy note released at the end of March, the agency proposed to delete cancer diagnosis codes from the list of payable codes if they contained the word “unspecified” in the description. The deletions were meant to go into effect on July 1.

Without these codes, providers would receive denials from CMS if they submitted claims using the unspecified codes. Although they could amend the claim and add a more specific code, the resubmission process would take longer and prevent timely payment.

Source: https://www.genomeweb.com/reimbursement-news/postponed-cms-proposal-would-remove-unspecified-cancer-dx-codes-impacting-test