tci Part B Insider - 2011 Issue 43

Q2043: New HCPCS Code Will Bring You $32,000 x 3 -- If You Bill It Properly

Include proper primary and secondary diagnosis codes to ensure payment. If your urologist performs a new treatment for asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) carcinoma of the prostate using the drug Provenge or Sipuleucel-T, take note of a new HCPCS code for 2012. Get to Know the Procedure Medicare allows a patient one treatment with Provenge in their lifetime, which includes three separate infusions within a two week period, says Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology at the State University of New York at Stony Brook. "Blood is taken from the patient...

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