AHA Coding Clinic® for HCPCS - 2008 Issue 1; FOR your INFORMATION

New diagnostic radiopharmaceutical edits

Effective January 1, 2008, the Outpatient Code Editor (OCE) will begin editing for the presence of a HCPCS code for the diagnostic radiopharmaceutical on the same claim as the separately payable nuclear medicine procedure. Claims not passing these edits will be returned to the provider. The nuclear medicine procedure-radiopharmaceutical edits are available on the CMS Web site at http://www.cms.hhs.gov/HospitalOutpatientPPS/ under Downloads. These edits may be updated quarterly as appropriate. ...

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