Medicare HETS 270/271 - Information Bulletin - HETS HCPCS Code Change Effective January 1, 2021

Dynamic List Information
Dynamic List Data
Date
Subject
Medicare HETS 270/271 - Information Bulletin - HETS HCPCS Code Change Effective January 1, 2021
User Community
HETS 270/271

Medicare HETS 270/271 Submitters:

Effective January 1, 2021 HCPCS code G0297 (Low dose CT scan [LDCT] for Lung Cancer Screening) will no longer be a valid code. Code 71271 (Computed Tomography, thorax, low dose for lung cancer screening, without contrast materials) will replace code G0297 effective January 1, 2021. HETS Submitters should modify their 270 requests to use the updated 71271 code instead of G0297. 

CMS recommends that all HETS submitters cease sending code G0297 on January 1, 2021 and instead utilize code 71271.  CMS has, however, made arrangements to temporarily allow HETS 270 requests with code G0297 to continue to process effective January 1, 2021.  HETS will cross-reference any such 270 request that is received, and if all other information on the 270 request is present and valid then HETS will return a proper 271 response with benefit information.  That 271 response would include next eligible dates for code 71271 instead of G0297.  This temporary logic would remain active until January 31, 2021.  HETS submitters must cease sending code G0297 no later than January 31, 2021.  Effective February 1, 2021 HETS would return a 999 response for any 270 request that includes code G0297.

Please contact the Help Desk if you have any questions.