ANCO/MOASC Seek Support for AB2440 (Laird)

ANCO and MOASC are joint sponsors of AB2440 (Laird), which would require the Department of Health Care Services (DHCS) to update CPT, HCPCS, and ICD-9 codes in a timely manner.

In order to be paid for serving DHCS/MediCal patients, physicians must know current coverage policy and use current procedure (CPT), drug (HCPCS), and diagnosis (ICD-9) codes. These coding systems are updated annually in October and Medicare requires their use no later than January 1st.

Unfortunately, DHCS does not implement the new codes until well after January 1st, usually not until the second half of the year. This creates an administrative burden on the practice because they need to keep two coding systems in place.

With respect to procedures, many new chemotherapy administration codes have been introduced that cannot be used because DHCS has not implemented current codes. And, some codes have been changed requiring practices to use old codes. This results in oncology practices losing fair compensation and reimbursement, a disincentive to treating DHCS beneficiaries.

Not updating the codes on time can also cost the state money. For example, current diagnosis coding for neutropenia (low white blood cell counts, often caused by chemotherapy, leading to a susceptibility to infection) requires five digits. Previous neutropenia coding only required four digits. Hence, current coding is more specific. Not all anti-neutropenia drugs will be paid for all the current codes. By using the four-digit code, DHCS is actually paying for uncovered diagnoses.

AB2440 (Laird) seeks to find a resolution to this problem. This bill would give the Department sixty days to implement the new codes. If the Department fails to meet this deadline, a provider will be allowed to bill utilizing current year codes or bill under a miscellaneous code until the new codes have been implemented. Further, the bill states that the Department cannot reject or delay a provider’s reimbursement claim due to the provider’s use of current year codes or miscellaneous codes.

Please send a letter of support for AB2440 to the following legislators by the close of business on Friday, March 14th:
Assemblymember Merv Dymally
State Capitol, Room 6005
Sacramento, CA 95814
FAX: (916) 319-2152

Assemblymember John Laird
State Capitol, Room 6026
Sacramento, CA 95814
FAX: (916) 319-2127

Send a copy to ANCO/MOASC’s advocates:

Kris Rosa
Noteware Government Relations
1201 K Street, Suite 1030
Sacramento, CA 95814
FAX: (916) 448-9777

Thank you for your support of AB2440.