Radiology Compliance Question of the Week
September 6, 2010
Question:
I would like to know the proper way to code for this procedure. We dose the patient with 100 mCi of 131I sodium iodide and then one week later we perform the scan. The problem arises when we bill Medicare.
CMS requires that every nuclear medicine exam have a radiopharmaceutical charge along with the chargeable exam. For this exam, the radiopharmaceutical (A9517) has already been charged along with the therapy code 79005. Currently, CMS denies payment because we are not submitting a radiopharmaceutical code.
Answer:
The Society of Nuclear Medicine (SNM) recommends that you hold the bill for the therapy and the radiopharmaceutical until the diagnostic study is done. You can find its comments at http://interactive.snm.org/index.cfm?PageID=8377&RPID=1995.
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