Health Policy Memo > Hospital Outpatient System
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Health Policy Memo > Hospital Outpatient System
CMS Releases Updates to Radiopharmaceutical Codes

January 20, 2010

The 2010 Healthcare Common Procedure Coding System (HCPCS) electronic file is posted on the Centers for Medicare & Medicaid Services (CMS) Web site with updated corrected files.  These files contain new, deleted, and revised HCPCS Level II codes and are effective with all payers and providers as of January 1, 2010.

Is your chargemaster up to date with the radiopharmaceutical changes?  The new, revised, and deleted codes are listed in the table below.

2010 HCPCS Level II Additions & Revisions

HCPCS CODE

Descriptor

Comments

• A9582

Iodine I-123 Iobenguane, diagnostic, per study dose, up to 15 millicuries

I-123 MIBG AdreView™

New Code Replaces

C9247 or A4641

• A9604

Samarium Sm 153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries

Quadramet®

New Code Replaces

A9605 "per 50 mCi description"

♦ A9500

Technetium TC-99M sestamibi, diagnostic, per study dose, up to 40 millicuries

"Up to amount" deleted

Cardiolite®

Mibi

• New code
♦ Code revision
C codes are only used in the HOPPS setting.

Put in typical disclosure language.  No AMA is needed as these are HCPCS codes (not AMA CPT).

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