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For other articles and previous issues click here. September 12, 2005 Briefing
Moments Radiopharmaceutical Diagnostic Imaging Agents Codes
and PET Scan Services Tracer Codes Applicable to CPT (Current Procedural
Terminology) 78491 and 78492 • A9526: Supply of Radiopharmaceutical Diagnostic Imaging Agent, Ammonia N-13 Physicians/practitioners billing the carrier: - A4641: Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified - A9526: Supply of Radiopharmaceutical Diagnostic Imaging Agent, Ammonia N-13 Tracer Codes Applicable to CPT 78459, 78608, 78609,
78811-78816 • A4641: Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified Physicians/practitioners billing the carrier: - A4641: Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified CPT Code Description • 78491: Myocardial imaging, PET, perfusion, single study at rest or stress • 78492: Myocardial imaging, PET, perfusion, multiple studies at rest and/or stress • 78608: Brain imaging, PET; metabolic evaluation • 78609: Brain imaging, PET; perfusion evaluation • 78811: Tumor imaging, PET; limited area (eg, chest, head/neck) • 78812: Tumor imaging, PET; skull base to mid-thigh • 78813: Tumor imaging, PET; whole body • 78814: Tumor imaging, PET with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; limited area (eg, chest, head/neck) • 78815: Tumor imaging, PET with concurrently acquired CT for attenuation correction and anatomical localization; skull base to mid-thigh • 78816: Tumor imaging, PET with concurrently acquired CT for attenuation correction and anatomical localization; whole body Payment Methodology for Rehabilitation Services
in Indian Health Services/Tribally Owned and/or Operated Hospitals
and Hospital-Based Facilities Other services that may be paid to IHS, tribe, and tribal organization facilities under the Medicare physician fee schedule include the following: • services furnished by a registered dietitian or nutrition professional (meeting certain requirements) as defined in §105 of Benefits Improvement and Protection Act of 2000 (BIPA) for medical nutrition therapy services for beneficiaries with diabetes or renal disease; • screening mammograms services based on the BIPA provision; • diagnostic tests performed by audiologists; and • telehealth services of professional consultations, office visits and other outpatient visits, individual psychotherapy, pharmacological management, and the psychiatric diagnostic interview examination as identified by CPT codes 99201 through 99215, 99241 through 99275, 90804 through 90809, 90862, and 90801. Medicare Part A Skilled Nursing Facility Prospective
Payment System Price Update and Health Insurance Prospective Payment
System Coding Updates The temporary add-on payments from section 101 of the Balanced Budget Refinement Act of 1999 and sections 312 and 314 of BIPA will no longer apply. The temporary AIDS 128% add-on from section 511 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 remains in effect. See Transmittal 630 for the list of Health Insurance Prospective Payment System codes to include on claims with dates of service on or after January 1, 2006. New HCPCS Codes and Systems Edits for Supplies
and Accessories for Ventricular Assist Devices Replacement Accessories and Supplies for VADs • Q0481: Microprocessor control unit for use with electric VAD, replacement only • Q0482: Microprocessor control unit for use with electric/pneumatic combination VAD, replacement only • Q0483: Monitor/display module for use with electric VAD, replacement only • Q0484: Monitor/display module for use with electric or electric/pneumatic VAD, replacement only • Q0485: Monitor control cable for use with electric VAD, replacement only • Q0486: Monitor control cable for use with electric/pneumatic VAD, replacement only • Q0487: Leads (pneumatic/electrical) for use with any type electric/pneumatic VAD, replacement only • Q0488: Power pack base for use with electric VAD, replacement only • Q0489: Power pack base for use with electric/pneumatic VAD, replacement only • Q0490: Emergency power source for use with electric VAD, replacement only • Q0491: Emergency power source for use with electric/pneumatic VAD, replacement only • Q0492: Emergency power supply cable for use with electric VAD, replacement only • Q0493: Emergency power supply cable for use with electric/pneumatic VAD, replacement only • Q0494: Emergency hand pump for use with electric or electric/pneumatic VAD, replacement only • Q0495: Battery/power pack charger for use with electric or electric/pneumatic VAD, replacement only • Q0496: Battery for use with electric or electric/pneumatic VAD, replacement only • Q0497: Battery clips for use with electric or electric/pneumatic VAD, replacement only • Q0498: Holster for use with electric or electric/pneumatic VAD, replacement only • Q0499: Belt/vest for use with electric or electric/ pneumatic VAD, replacement only • Q0500: Filters for use with electric or electric/pneumatic VAD, replacement only • Q0501: Shower cover for use with electric or electric/pneumatic VAD, replacement only • Q0502: Mobility cart for pneumatic VAD, replacement only • Q0503: Battery for pneumatic VAD, replacement only, each • Q0504: Power Adapter for pneumatic VAD, replacement only, vehicle type • Q0505: Miscellaneous supply or accessory for use with VAD The Medicare Part A payment includes the supplies and accessories for the VAD. After the patient is discharged from the hospital, Medicare payment, under Part B, can be made for the medically necessary supplies and replacement accessories, unless these items are covered under a manufacturer’s warranty. See CMS Transmittal 613 for complete claims processing instruction. — Barbara Bosler, MS, RHIA, is a Michigan-based consultant in business practice healthcare functions. Reference |
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