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Official Description

Brachytherapy source, non-stranded, palladium-103, per source
Short Descr Brachytx, non-stranded,p-103
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
SG Ambulatory surgical center (asc) facility service
GW Service not related to the hospice patient's terminal condition
JW Drug amount discarded/not administered to any patient
Date
Action
Notes
2007-07-01 Added Code added 7/1/2007
Code
Description
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