June 3, 2013
The 2013-14 Current Procedural Terminology (CPT) electronic Category III file was released by the American Medical Association (AMA) on December 27, 2012. New, deleted and revised codes will be effective on July 1, 2013. Important changes were made for some new nuclear medicine services, the new nuclear medicine codes are listed in the table below:
APC 0389 Level I cardiac imaging has a hospital Outpatient Prospective Payment System (OPPS) 2013 national rate of $308.99, this payment includes the payment for the diagnostic radiopharmaceutical as A9582 Iodine I-123 iobenguane, diagnostic, per study dose, up to 15 millicuries is currently paid as packaged with a status indicator “n” in OPPS. We understand that application for “new technology” has been made; therefore we suggest you check back for any (OPPS) payment changes. Medicare OPPS implements changes quarterly, (January, April, July and October).
MPFS = Medicare Physician Fee Schedule which includes Independent Diagnostic Testing Facilities (IDTFs).
For more details see the SNM Practice Management Coding Corner article on AdreView™.
For additional AMA CPT Category III Code additions, revisions and deletions please download the 2013-4 AMA Category III File on the AMA web site. Or you may paste the link below into your browser http://www.ama-assn.org/resources/doc/cpt/cptcat3codes.pdf
For more information, consult your AMA CPT Category II file or contact the SNMMI HPRA staff at firstname.lastname@example.org.