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Issue 2006-03, March 2006
MLN Matters. . .Information for Medicare Providers
(Issued by the Centers for Medicare & Medicaid Services)
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Note: This article was revised on February 3, 2006 to reflect a revised CR4270. The changes made show that A9555 replaces Q3000 and A9552 replaces C1775. All other information remains the same. |
Provider Types Affected
Providers who submit claims to Medicare fiscal intermediaries (FIs) for PET scan services provided to Medicare beneficiaries
Background
This article is based on CR4270, which updates the Medicare Claims Processing Manual (Publication 100-04), Chapter 13, Section 60.3.2 (Tracer Codes Required for PET Scans) to include two new HCPCS codes for radiopharmaceutical diagnosis imaging agents (tracers) applicable to PET scan services.
Key Points
Effective for claims dates of service on or after January 1, 2006:
- A9555 replaces Q3000; and
- A9552 replaces C1775.
Effective for dates of service on or after January 1, 2006:
- HCPCS codes Q3000 and C1775 are deleted.
Additional Information
Tracer Codes Required for PET Scans for Institutional Providers
Billing Their Fiscal Intermediary
The following are tracer codes applicable to CPT 78491 and 78492:
HCPCS |
Description |
*A9555 |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Rubidium RB-82, Diagnostic, Per study dose, Up To 60 Millicuries |
*Q3000 |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Rubidium RB-82 (Deleted effective 12/31/05) |
A9526 |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Ammonia N-13 |
*Note: For claims with dates of service prior to January 1, 2006, providers should report Q3000 for supply of radiopharmaceutical diagnostic imaging agent, Rubidium RB-82. For claims with dates of service January 1, 2006 and later, providers report A9555 for radiopharmaceutical diagnostic imaging agent, Rubidium RB-82 in place of Q3000.
The following are tracer codes applicable to CPT codes 78459, 78608, 78609, 78811-78816:
HCPCS |
Description |
*A9552 (OPPS Only) |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Fluorodeoxyglucose F18, FDG, Diagnostic, Per study dose, Up to 45 Millicuries |
*C1775 |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Fluorodeoxyglucose F18 (Deleted effective 12/31/05) |
A4641 |
Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified |
*Note: For claims with dates of service prior to January 1, 2006, providers report C1775 for supply of radiopharmaceutical diagnostic imaging agent, Fluorodeoxyglucose F1. For claims with dates of service January 1, 2006 and later, providers report A9552 for radiopharmaceutical diagnostic imaging agent, Fluorodeoxyglucose F18 in place of C1775.
Implementation Date
This change will be implemented in Medicare systems on July 3, 2006.
Relevant Links
CR4270 is the official instruction issued to your FI regarding this change. CR4270 may be found by going to http://www.cms.hhs.gov/Transmittals/downloads/R822CP.pdf  on the CMS Web site.
Please refer to your local FI if you have questions about this issue. To find their toll-free phone number, go to http://www.cms.hhs.gov/apps/contacts/  on the CMS Web site.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.
For more information, visit the Medlearn Matters Web page at: http://www.cms.hhs.gov/MedlearnMattersArticles.
Pub. 100-4, Transmittal# R822CP, CR# 4270
Medlearn Matters Number: MM4270 Revised
Related CR Release Date: February 1, 2006
Effective Date: January 1, 2006
Implementation Date: July 3, 200
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