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Official Description

Brachytherapy source, non-stranded, high dose rate iridium-192, per source
Short Descr Brachytx, non-str,hdr ir-192
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(T)
ASC Payment Group Code YY – 1/01/2008
BETOS I4B – Imaging/procedure - other
TOS Code(s) 6 – Therapeutic radiology
Added Date 4/1/2001
APC Status Indicator Brachytherapy Sources
ASC Payment Indicator Brachytherapy source paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
MUE 10
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
Date
Action
Notes
2001-04-01 Added Code added 4/1/2001
Code
Description
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