Pharmacy Question for the Week of February 14, 2022

Question:

Can give more details about the status indicator of radiopharmaceuticals grouped under N?

Answer:

The payment received by hospital outpatient departments for diagnostic radiopharmaceuticals is bundled with the major procedure performed. CMS has assigned most diagnostic radiopharmaceuticals with a status indicator “N.” For diagnostic radiopharmaceuticals with status indicator “N,” CMS bundles the cost into the procedure payment rate. CMS and medical specialty societies strongly encourage facilities to code and bill separately for radiopharmaceuticals regardless of their status indicator. CMS also states, “All these charges play a role in defining future hospital payment.”

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