Health Information Management

Q&A: What items will receive pass-through payment in July?

APCs Insider, June 20, 2014

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Q: Will any new items receive pass-through payment beginning in July?
 
A: Yes, CMS granted is a new brachytherapy source, cesium-131 chloride solution, pass-through status beginning July 1, 2014, and established HCPCS code C2644 (brachytherapy source, cesium-131 chloride solution, per millicurie) to represent the new source. The unadjusted payment is $18.97 per millicurie.
CMS created a new grouping to classify brachytherapy sources to separately identify them from other groups of seeds or sources, by mandate of Section 1833 (t)(2)(H) of the Social Security Act. The grouping must reflect the number, isotope, and radioactive intensity of the sources furnished. 
Be sure to communicate with the appropriate staff in the departments that provide brachytherapy sources to ensure they report the appropriate number of units. This HCPCS code is defined as per millicurie and will be reimbursed based on that unit of measure; providers want to be sure that the units reported reflect the units provided/utilized in order to secure appropriate and entitled reimbursement. 
 
Editor’s note: Andrea Clark, RHIA, CCS, CPCH, chairman and founder of Health Revenue Assurance Associates, Inc., in Plantation, Florida, answered this question.

 



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