NOPR Billing Alert: CMS Posts Instructions Regarding Deletion of QR Modifier used for NOPR Claims - Effective January 1, 2008 Use Q0 Modifier
On Friday Jan. 18, 2008, CMS released Transmittal R1418CP, CR 5805 notifying PET facilities and Medicare Administrator Contractors that the discontinued QR (and QA) and QV HCPCS modifiers are replaced by the new modifiers Q0 (zero) and Q1, respectively, to identify investigational and routine clinical services provided in a clinical research study approved by Medicare. These two new modifiers are included in the 2008 Annual HCPCS Level II Update. The CR 5805 instructions are to be implemented by the Medicare Contractors no later than April 7, 2008.
Specifically, effective for dates of service (DOS) on or after Jan. 1, 2008, modifier QR currently used in the National Oncologic PET Registry (NOPR) is replaced with modifier Q0 (zero). Additionally, QA is also replaced by Q0 and QV is replaced by Q1. CMS has given the contractors until April 7, 2008 to implement these changes; however, we anticipate that some contractors might be ready to accept these claims sooner. PET facilities are encouraged to update their charge-masters to include theses new modifiers. While all contractors are required to accept claims with the new modifiers as of April 7, facilities are advised to check with their local contractors to ascertain the exact date the contractors' systems will be ready to process claims.
Claims with a DOS prior to Jan. 1, 2008, should continue to be submitted with the QR modifier.
The NOPR investigators and staff are fully aware that participating PET facilities are understandably distressed by CMS' announcement in late 2007 that the QR modifier was being eliminated at the end of the year, and that the new modifier would not be implemented until early April 2008. We have expressed our concerns to CMS.