Oncology Coding Article – New CPT Codes for the Administration of Zevalin


Medical Oncology Code Changes

According to the Federal Register, November 7, 2003 (OPPS Final Rule) and effective in 2004, there will be new CPT codes for the administration of Zevalin:

    78804     Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body, requiring two or more days imaging

    79403     Radiopharmaceutical therapy, radiolabeled monoclonal antibody, by intravenous infusion

    These codes will replace the HCPCS codes used for 2003 (G0273 & G0274), which have been deleted. In addition, the following HCPCS codes will be reported for the radiopharmaceuticals:

                A9522             Indium 111 ibritumomab tiuxetan

                A9523             Yttrium 90 ibritumomab tiuxetan

    Other hospital billing news includes the deletion of HCPCS codes G0256 and G0261 for prostate seed brachytherapy. Hospitals will now report this service with CPT codes 77778 and 55859, and will again report the seeds with pass-through codes:

    C1718            Brachytherapy source, iodine 125

    C1720            Brachytherapy source, palladium 103

    Cindy C. Parman, CPC, CPC-Hcparman-9340957
    principal and co-founder of Coding Strategies, Inc. in Atlanta, GA. Cindy is a current member of the Advisory Board for the American Academy of Professional Coders (AAPC) and a faculty instructor for AMA Solutions, a subsidiary of the American Medical Association.  She serves as the Consulting Editor of the Radiology Coding Alert and is on the Editorial Advisory Board of General Surgery Coding Alert and Pain Management Coding Alert.