ACloserLook Reimbursement Issues in Diagnostic Imaging

Radiopharmaceutical OCE Edits Updated

CMS has issued revised Outpatient Code Editor (OCE) edits for diagnostic radiopharmaceuticals and nuclear medicine procedures. CMS has added code A9517 Iodine I-131 sodium iodide capsule(s), therapeutic, per millicurie. CPT code 78016 Thyroid carcinoma metastases imaging; limited area with additional studies (eg, urinary recovery) is being removed from the list of CPT codes in HOPPS requiring at least one radiopharmaceutical on the claim in order to get full payment.

To download the edits, go to http://tiny.cc/f3Glc

Spring 2008 Newsletter


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