ACloserLook Reimbursement Issues in Diagnostic Imaging

New OCE Edits Implemented for Nuclear Medicine

Effective January 1, 2008, CMS implemented an Outpatient Code Edit (OCE) resulting in the return of (for correction) any claim for a nuclear medicine procedure that does not contain a HCPCS Level II radiopharmaceutical code. CMS does not state any specific radiopharmaceutical must be used with a particular nuclear medicine CPT procedure code, but one must be included on the claim form.

For further details, go to:
http://www.cms.hhs.gov/Transmittals/2008Trans/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=2&sortOrder=descending&itemID=CMS1207573&intNumPerPage=2000

Winter 2008 Newsletter


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