EMC Formats

130 - EMC Formats (Rev. 3227, Issued: 04-02-15, Effective; ASC-X12: January 1, 2012 Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors: June 11, 2013, ICD-10: Upon Implementation of ICD-10 Implementation: ASC X12: November 10, 2014 Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for Solid Tumors: May 19, 2014 - MAC Non-Shared System Edits; July 7, 2014 - CWF development/testing, FISS requirement development; October 6, 2014 - CWF, FISS, MCS Shared System Edits), ICD-10: Upon Implementation of ICD-10) Billing instructions for the ASC X12 837 institutional claim format can be found in chapter 24 of this manual or, for Form CMS-1450 can be found in chapter 25 of this manual. Each revenue code requires a HCPCS code, modifier if applicable, units, line- item date of service, and charge. Billing instructions for the ASC X12 837 professional claim format can be found in chapter 24 of this manual or for Form CMS-1500 can be found in this manual, Chapter 26, “Instructions for Completing Form CMS-1500."