HCPCS Code C2639

Official Description

Brachytherapy source, non-stranded, iodine-125, per source

Short Descr	Brachytx, non-stranded,i-125
Coverage	Special coverage instructions apply
Pricing Indicator(s)	53 – Statute
MPI	A – Not applicable, as HCPCS priced under one methodology
Statute	1833(t)(2)
ASC Payment Group Code	YY – 1/01/2008
BETOS	I4B – Imaging/procedure - other
TOS Code(s)	4 – Diagnostic radiology
Added Date	7/1/2007
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	150
MUE	Not applicable/unspecified.
OTS Orthotic	No
CCS Clinical Classification	211 - Therapeutic radiology

Drug amount discarded/not administered to any patient

Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.