Health Information Management

Pay-per-view: CMS adds new radiopharmaceutical, modifier

APCs Insider, November 11, 2011

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CMS reclassified HCPCS code C9406 (iodine I-123 ioflupane, diagnostic, per study dose, up to 5 millicuries) as a radiopharmaceutical as part of the October updates to the I/OCE. The change is retroactively effective to July 1.

The change is significant for two reasons, says Dave Fee, MBA, product marketing manager of outpatient products at 3M Health Information Systems in Murray, UT. First, if a hospital receives the radiopharmaceutical at no charge, it must append modifier -FB (item provided without cost to provider, supplier or practitioner, or credit received for replacement device [Examples, but not limited to: covered under warranty, replaced due to defect, free samples]) to the procedure code.

Continue reading “CMS adds new radiopharmaceutical, modifier ” on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the November issue.



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