CMS Releases 2006 HCPCS Level II Annual Update

October 28, 2005

CMS Releases 2006 HCPCS Level II Annual Update

On October 27, the Centers for Medicare and Medicaid Services (CMS) released the 2006 Healthcare Common Procedure Coding System (HCPCS) Level II code set. This file contains over 60 changes for nuclear medicine radiopharmaceuticals and drugs, which will become effective January 1, 2006.

The SNM was pleased to receive praise from the CMS HCPCS working group Director, Cynthia Hake, as stated in a letter to the SNM thanking the Society for its application to modify the HCPCS Code Set relating to radiopharmaceuticals. In the letter Ms. Hake states, "I would also like to thank you and the Society of Nuclear Medicine for your patience, and for contributions of research and expert input, as we processed this extraordinarily large and complex request."

The SNM Coding & Reimbursement working group began this HCPCS Level II project over two years ago. The project goal was to bring consistency and structure to radiopharmaceutical codes based on both current medical practices and facilities purchase practices. "It has been a lot of collaboration, education and hard work for both the CMS HCPCS working group and the SNM Coding & Reimbursement working group members,” said Denise Merlino, SNM’s coding adviser and a key contributor to this project. “I believe both groups worked together for the common goal. It was a unique experience with results well worth the efforts. I would also like to commend the CMS working group for their successful implementation of a new, more transparent HCPCS process," said Merlino. This 2006 HCPCS cycle was the first time ever for the community to experience a "sneak peak" of the HCPCS working group's proposed drugs and radiopharmaceuticals, which occurred back in June of 2005. This allowed the opportunity for public comment, an important part of this new process.

As always, the SNM will prepare educational materials with these new, revised and deleted 2006 HCPCS level II that will be posted in the practice management section of the SNM web site in the near future. In the mean time the complete file containing the 2006 HCPCS Annual Update can be found online at: http://www.cms.hhs.gov/providers/pufdownload/anhcpcdl.asp.