Accurate billing for therapeutic radiopharmaceuticals and brachytherapy services remains one of the most error-prone areas in outpatient coding—especially with the added complexity of CMS’s quarterly OPPS updates. The April 2025 changes introduced new HCPCS codes and adjusted payment indicators, significantly increasing the risk of misreporting. Combined with common confusion around packaging logic, JW/JZ modifiers, and the separate reporting requirements for brachytherapy planning, imaging, and source placement, the stakes for compliance and revenue accuracy have never been higher. Whether you’re working in oncology coding, revenue integrity, or billing compliance, staying ahead of these changes is essential to avoiding denials and ensuring proper reimbursement.

This specialized webcast will provide the clarity and practical guidance you need to confidently navigate these challenges. Through real-world examples and CMS-backed instruction, you’ll learn how to apply the latest rules for radiopharmaceutical billing, validate correct unit calculations, and distinguish which services are separately payable under OPPS. You’ll also gain critical insights into proper use of JW and JZ modifiers and correct code selection for brachytherapy-related procedures. Designed for coders, auditors, billing professionals, and managers in outpatient and hospital settings, this session will help you reduce compliance risk and strengthen revenue performance while walking away with practical tools you can immediately apply to real-world coding scenarios.

Why This is Relevant:

With increasing scrutiny on HCPCS unit accuracy, wastage reporting (JW/JZ modifiers), and correct use of packaging logic, mistakes can lead to denials, underpayments, and compliance exposure. Frequent updates, like new HCPCS codes and payment indicator changes, only add to the complexity.

Add in brachytherapy’s multilayered billing requirements for planning, source placement, and imaging, and it’s easy to see how errors happen even among seasoned professionals.

Learning Objectives:

• Identify the correct HCPCS codes and billing units for therapeutic radiopharmaceuticals based on dose administered.
• Apply OPPS packaging rules and status indicators to determine which services are separately reimbursed.
• Use JW and JZ modifiers appropriately when reporting discarded versus non-discarded drug amounts.
• Accurately report brachytherapy planning, source placement, and imaging guidance services.
• Recognize and avoid coding and billing errors frequently cited in CMS audits and reviews.

Who Should Attend:

Medical Coders (Outpatient & Hospital-based), Radiation Oncology Coders, Compliance & Billing Specialists, Revenue Integrity Analysts, HIM Professionals, Cancer Center Managers, Coding Auditors, Nuclear Medicine Technologists (in coding/billing roles), Practice Managers in Oncology or Imaging Settings.