"Until practices get used to the new coding scheme, physicians, technologists, coders and others responsible for the proper coding of nuclear medicine procedures may find these changes confusing," said Gary Dillehay, M.D., FACNP, FACR, chair of SNM's Coding and Reimbursement Committee. To sort through the CMS additions, revisions and deletions--which become effective Jan. 1, 2006--SNM is offering two reimbursement seminars to help health care practitioners code correctly and safely, he added. "Nuclear medicine professionals work hard to provide the highest quality patient care; they should use the same care to ensure that coding complies with current policy and that they are properly reimbursed," said Dillehay.
"While the new HCPCS manual includes plenty of changes, the news is virtually all good for the nuclear/molecular imaging community," said SNM's coding adviser Denise A. Merlino, MBA, CNMT, FSNMTS. "CMS has changed the code definitions to make them match the way practices purchase and administer radiopharmaceuticals to their patients," she added. "Practices should immediately begin to update the charge description master or chargemaster, effective January 1, 2006," said Merlino, indicating that the comprehensive and hospital-specific listing of each item that can be billed to a patient, payers or other health care providers will need "a major overhaul."
For example, code A9515 had been defined as "supply of radiopharmaceutical diagnostic imaging agent, technetium Tc 99 mm pentetate, per mci," said Merlino. The new code--A9539-- provides for "technetium TC-99m pentetate, dia
Contact: Maryann Verrillo
Society of Nuclear Medicine