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Precision Medicine Institute Live Webinar Briefing: Usage of Medicare ICD-10 NOS Codes

 Precision Medicine Institute/Diaceutics

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In June of 2021, the Centers for Medicare and Medicaid Services (CMS) released a transmittal (No. 10832) that would remove from use certain codes used to bill Medicare in connection with a policy titled National Coverage Determination (NCD) 90.2, which outlines when Medicare will cover next-generation sequencing (NGS)-based genetic tests. The codes slated for removal include ICD-10 “not otherwise specified” (NOS) codes, which has caused concern among advocates who note that these codes are frequently used for patients with advanced cancer when incomplete data about a tumor's original location in the body make it inappropriate for clinicians to use alternative reimbursement codes.

During this briefing, researchers from Diaceutics will present new data on the number and percentage of patients receiving NGS testing that may be impacted by the retiring of these diagnosis codes.

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