Oncology & Hematology Coding Alert

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