Brachytherapy-Anyone having any

kd2471

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Anyone having any luck with getting reimbursed from Medicare for Brachytherapy seeds (C-131 non-stranded) HCPCS Code 2643. We started doing these in January 08 and are having problems getting paid. When billing electronically we have to fax invoice at same time as electronic with EDI cover sheet. These keep getting rejected.
 

mbort

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Are you inputting any info in box 19 on the HCFA? What other codes are you billing?

The C2643 has a payment indicator of H7 so ultimately it should be paid just need to figure out exactly how Medicare wants it.

I've only had to code them a couple of times as most of the Radiology oncologists supply and bring them to the ASC.
 

kd2471

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Brachytherapy

Yes I am putting info in Box 19 that says "Invoice/documentation faxed" per EDI instructions. As of July 1 the C2643 code will be used for ASC's. Right now it's a question of whether Q3001 or C2643 is used. As you know Medicare is not the greatest for helping out.
 

scgcpc2002

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brachytherapy coding

We had problems in the beginning with Medicare not paying on any brachy procedures...found out the problem was on their end. In sending a redetermination along w/op report and invoice for the seeds these are now getting paid. Hope this helps
 
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