AHA Coding Clinic® for HCPCS - 2008 Issue 3; FOR your INFORMATION

CMS adds HCPCS codes to satisfy radiopharmaceutical edit for nuclear medicine procedures

Effective July 1, 2008, CMS has included all HCPCS codes for diagnostic radiopharmaceuticals, therapeutic radiopharmaceuticals, and brachytherapy sources as radiolabeled products that satisfy the edit requirements for nuclear medicine procedures. Since January 1, 2008, for OPPS reporting, payment for diagnostic radiopharmaceuticals has been packaged into payment with the associated nuclear medicine procedure. To ensure that they were able to capture the diagnostic radiopharmaceutical costs for future rate-setting purposes, CMS implemented edits to the Integrated Outpatient Coding Editor (I/OCE) that require a diagnostic radiopharmaceutical to be present on the same claim as a nuclear medicine procedure. However, since the addition...

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