Radiology Coding Alert

Coding accuracy will hinge on watching units.

CMS has announced HCPCS changes expected for 2014, and you don’t want to miss what’s planned for the MRI contrast Dotarem and diagnostic adenosine.

Dotarem Earns Its Own Code

The MRI contrast agent sold under the name Dotarem should have a new code in 2014. CMS has posted a preliminary decision to create A95XX (Injection, gadoterate meglumine, 0.1 mL).

Physicians may order Dotarem for MRIs of the brain (intracranial), spine, and associated tissue. The contrast helps the physician visualize areas “with disruption of the blood brain barrier (BBB) and/or abnormal vascularity,” according to the May 8, 2013, HCPCS public meeting agenda.

J0152 May Be Ditched in 2014 for Adenosine

If your practice provides nuclear cardiac stress tests, take note. The way you report units for adenosine may change next January.

CMS has posted a preliminary decision to discontinue current code J0152 (Injection, adenosine for diagnostic use, 30 mg [not to be used to report any adenosine phosphate compounds; instead use A9270]).

In its place, CMS proposes to introduce a new J code that will change the per-unit amount from 30 mg to 1 mg in the definition: Injection, adenosine for diagnostic use, 1 mg (not to be used to report any adenosine phosphate compounds; instead use A9270). If approved, the new code will be effective Jan. 1, 2014.

Resource: You’ll find CMS’s HCPCS public meeting downloads available at www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings.html. Or you can go straight to the May 8 meeting agenda at www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/Downloads/May8th-Drug-Agenda.pdf.