Oncology Coding Article – Outpatient Prospective Payment System (OPPS)

0

Medical Oncology Code Changes

ACOA Coding Minute

OPPS Brachytherapy C Codes

In addition to the Level 1 HCPCS codes (aka, CPT codes), hospitals also have to be certain that national Level 2 HCPCS codes are updated to the Charge Description Master (CDM). A subset of these Level 2 codes include ‘C’ codes that are reported for the radioactive source used for outpatient radiation therapy.

C1716

Brachytherapy source, Gold 198, per source

C1717

Brachytherapy source, High Dose Rate Iridium 192, per source

C1718

Brachytherapy source, Iodine 125, per source

C1719
C1720

Brachytherapy source, Palladium 103, per source

C2616

Brachytherapy source, Yttrium-90, per source

C2632

Brachytherapy solution, Iodine125, per mCi

C2633

Brachytherapy source, Cesium-131, per source

C2634 Brachytherapy source, High Activity, Iodine-125, greater than 1.01 mCi (NIST), per source  
C2635
C2636

Brachytherapy linear source, Palladium-103, per 1MM

In addition to the codes for the sources, there are codes to capture the number of needles and catheters used (i.e., C1728, C1715).  While these particular codes do not result in additional reimbursement, CMS will use them for tracking to determine if payment for related APCs needs to be increased in the future.

For additional information, see: http://www.cms.hhs.gov

Watch for more 2005 coding changes in the upcoming months.  Review previous Coding and Reimbursement Updates from the Academy’s Website.

This Coding and Reimbursement Update was prepared by:
Cindy C. Parman, CPC, CPC-H
Coding Strategies, Inc.

Phone: (877) 6CODING

Fax: (770) 445-0407

[email protected]
www.codingstrategies.com

Cindy C. Parman, CPC, CPC-Hcparman-4657648
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.  

 Back