News You Can Use:
Red Flag - CMS Adds New Brachytherapy Facility Codes
Published on Mon Oct 01, 2007
Master reporting strand units from the get-go
If you-re preparing to send out a claim reporting C1718, hold on. CMS deleted that code - plus two more - for services on or after July 1.
The lowdown: CMS created new brachytherapy source HCPCS C codes to identify the three brachytherapy forms (iodine, palladium and cesium) and to reflect the two different brachytherapy source versions (stranded and non-stranded), says Benji Oden, RHIT, managing editor for the Coding Clinic for HCPCS and American Hospital Association senior staff specialist. Example: -While HCPCS C codes C1718, C1720 and C2633 identified the forms of brachytherapy, they did not reflect the different versions,- so CMS replaced them.
Payers other than Medicare may recognize C codes, so contact your payers to learn their rules on these codes, Oden says.
Don't miss: When you bill stranded sources, you should report the number of units based on the number of brachytherapy sources in the strand and not as one unit per strand.
Crucial: You should report HCPCS C codes only for facility (technical) services. OPPS hospitals must use these codes.
Source: Find out more from CMS at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5623.pdf and www.cms.hhs.gov/transmittals/downloads/R1259CP.pdf, which also discusses the addition of C9728 (Placement of interstitial device[s] for radiation therapy/surgery guidance [e.g., fiducial markers, dosimeter], other than prostate [any approach], single or multiple).
New or Revised Brachytherapy Source Codes
|
HCPCS |
Descriptor (changes in bold) |
Change |
|
C1716 |
Brachytherapy source, non-stranded, Gold-198, per source |
Revised |
|
C1717 |
Brachytherapy source, non-stranded, high dose rate Iridium-192, per source |
Revised |
|
C1719 |
Brachytherapy source, non-stranded, non-high dose rate Iridium-192, per source |
Revised |
|
C2616 |
Brachytherapy source, non-stranded, Yttrium-90, per source |
Revised |
|
C2634 |
Brachytherapy source, non-stranded, high activity, Iodine-125, greater than 1.01 mCi (NIST), per source |
Revised |
|
C2635 |
Brachytherapy source, non-stranded, high activity, Palladium-103, greater than 2.2 mCi (NIST), per source |
Revised |
|
C2636 |
Brachytherapy linear source, non-stranded, Palladium-103, per 1 MM |
Revised |
|
C2637 |
Brachytherapy source, non-stranded, Ytterbium-169, per source |
Revised |
|
C2638 |
Brachytherapy source, stranded, Iodine-125, per source |
Added |
|
C2639 |
Brachytherapy source, non-stranded, Iodine-125, per source |
Added |
|
C2640 |
Brachytherapy source, stranded, Palladium-103, per source |
Added |
|
C2641 |
Brachytherapy source, non-stranded, Palladium-103, per source |
Added |
|
C2642 |
Brachytherapy source, stranded, Cesium-131, per source |
Added |
|
C2643 |
Brachytherapy source, non-stranded, Cesium-131, per source |
Added |
|
C2698 |
Brachytherapy source, stranded, not otherwise specified, per source |
Added |
|
C2699 |
Brachytherapy source, non-stranded, not otherwise specified, per source |
Added |
Deleted Brachytherapy Source Codes
HCPCS |
Descriptor |
|
C1718 |
Brachytherapy source, Iodine-125, per source |
|
C1720 |
Brachytherapy source, Palladium-103, per source |
|
C2633 |
Brachytherapy source, Cesium-131, per source |
