Modifier CT – New Reporting guidelines
The definition for modifier CT has changed, effective January 1, 2016. The way one reports claims for computed tomography (CT) scans will change with the new definition. Modifier CT Computed tomography services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association (NEMA) XR-29-2013 standard.
?Attributes? of this standard are:
- DICOM dose structured reporting
- Pediatric and adult reference protocols
- CT dose check
- Automatic exposure control
When Modifier CT has to be reported:
Report modifier CT with the following CPT(R) radiology codes when the service is furnished on non-NEMA standard XR-20-2013-compliant equipment:
- 70450-70498
- 71250-71275
- 72125-72133
- 72191-72194
- 73200-73206
- 73700-73706
- 74150-74178
- 74261-74263
- 75571-75574
If This Doesn?t Comply:
Providers should take steps now if they learn their equipment is not compliant. They should contact their vendors immediately to see if they can get compliant as soon as possible. If that?s not possible, then they will need to immediately determine how to reporting modifier ?CT.
As it applies to the technical component of the procedure, providers that fail to attest to this standard beginning this year will be subjected to a 5 percent payment reduction for all CT-designated procedures for Medicare. The penalty will be 15 percent, beginning in 2017 and subsequent years. System attestation by providers will be verified through the periodic supplier accreditation process (e.g. Joint Commission, ACR, IAC, etc.).
For more information on the modifier, see CMS Transmittal 3402.