Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
Reader Question: Yes, You Can Report C1879 Along With 19125
Question: Our radiologist will be purchasing the needles and clips he'll use during stereotactic biopsy. Are these included in Medicare's reimbursement for 19125? If not, what HCPCS code should we report for the supplies?
North Dakota Subscriber
Answer: If you're reporting the service to Medicare on a CMS-1500, all supplies will be included with the fee for 19125 (Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion). However, the implantable tissue marker clips still can be reported separately under HCPCS code C1879 (Tissue marker; implantable). HCPCS does not include a code for the needles, so...
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