Last Modified: 2/21/2018 Location: FL, PR, USVI Business: Part A, Part B
HETS application: HCPCS code changes and new preventive codes
The Centers for Medicare & Medicaid Services (CMS) released several changes to the Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS) application, which went into effect November 4, 2017. The changes impact providers who use First Coast Service Options’ (First Coast’s) Secure Provider Online Tool (SPOT) to access eligibility data through HETS.
Preventive HCPCS Code Changes
HETS 270/271 now returns only preventive HCPCS code information for the current date, instead of the current calendar year.
Newly Supported Preventive HCPCS Codes
HETS 270/271 now supports the following HCPCS codes:
• 81528 - Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
• G0297 - Low dose CT scan (LDCT) for lung cancer screening
• G0442 - Annual alcohol misuse screening, 15 minutes
• G0443 - Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes
• G0472 - Hepatitis C antibody screening, for individual at high risk and other covered indications
• G0473 - Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes
• G0475 - HIV Antigen/antibody, combination assay, screening
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.