Download 2016 Coding Sheet

January 2016
Coding Sheet
Pre-Treatment Mapping and
Microspheres Administration
Hospital Outpatient, ASC and
Physician Services
SIR-Spheres® microspheres
Treatment Flow Chart
(Performed in Outpatient Setting OPPS )
Phase 1: Pre-Treatment Evaluation
Phase 2: SIR-Spheres microspheres
Administration
Patient Referral to Interventional Radiology
SIR-Spheres microspheres
(Ordered one week prior to treatment)
Screening Lab Tests
(Hepatic Panel - required for treatment)
TREATMENT PLAN
DOSE CALCULATION
Pre-Treatment Mapping
(Angiography and Embolization)
(Tc
99
Radiation Oncology/Nuclear
Medicine/or IR/AU
Treatment Planning & Radiation Dosimetry
Nuclear Medicine
– MAA Scan for Shunting Lung)
DAY OF TREATMENT
20% or Greater
Shunting?
Patient may not
be Eligible
Less than 20%
Shunting?
Diagnostic
Radiology
CT Abdomen;
MRA Abdomen
(if applicable);
3D Post Processing;
Baseline PET
(if applicable)
Patient Eligible –
Schedule Treatment
SIR-Spheres microspheres Administration
Place arterial catheter; tumor embolization;
Intra-arterial yttrium-90 administration
Post-Procedure Observation
(Liver imaging, SPECT or Planar)
Post-Treatment Follow Up
6 weeks, 3 and 6 months
SIR-Spheres® microspheres Therapy
Coding and Medicare National Average Reimbursement
2016 Hospital Outpatient (OPPS), Ambulatory Surgery Center (ASC) and
2016 Physician Services (MPFS)
Medicare 2016 OPPS payment rates are reflective of Medicare 2016 OPPS Final Rule, Addendum B Medicare physician
payment rates included in this coding guide are based on current law, including the Pathway for SGR Reform Act of 2013 and
the MPFS payment rates reflecting policies adopted in CY 2016 Medicare Physician Fee Schedule Final Rule that appeared in
the Federal Register on November 1, 2015, with updated conversion factor files published January 15, 2016. Physician
payment rates are based on conversion factor $35.8043 through December 31, 2016.
Coding for administration of SIR-Spheres microspheres can be complex. There is no consensus or consistency in the
coding/billing for the administration of SIR-Sphere microspheres. This coding guide provides SIR-Spheres Microspheres PreTreatment and Day of Treatment coding options. Payer policies should be reviewed for coverage & coding guidelines.
FDA LABELED INDICATIONS FOR USE
SIR-Spheres microspheres: Colorectal cancer metastasized to the liver in combination with hepatic arterial chemotherapy
(FUDR) – Full PMA approval
Provider of Service
Place of
Service Code
Hospital Outpatient
22
Hospital Outpatient Prospective Payment System (OPPS) payments made based
on CPT codes under Ambulatory Payment Classifications (APC)
24
ASC Payment System is linked to the OPPS, paying ~65% of the APC payment
11
Medicare Physician Fee Schedule (MPFS) payments are made based on relative
values assigned to CPT codes (work, practice and malpractice expense)
Ambulatory Surgery
Center (ASC)
Physician
Freestanding Office
Medicare Payment Methodology
IMPORTANT PROVIDER NOTICE!
National Correct Coding Initiative (CCI) Edits may result in coding conflicts for various treatments and procedures. Providers
should carefully review each quarter’s CCI edit updates. CCI Edits may be downloaded from the CMS website
at: http://www.cms.gov/NationalCorrectCodInitEd/. Questions, concerns or comments regarding specific NCCI edits, may
be submitted in writing to:
National Correct Coding Initiative
Correct Coding Solutions LLC (Fax #: 317-571-1745)
P.O. Box 907
Carmel, IN 46082-0907
Attention: Niles R. Rosen, MD, Medical Director & Linda S. Dietz, RHIA, CCS, CCS-P, Coding Specialist
Page 3
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416.
Coding Options for SIR-Spheres® microspheres Therapy
Pretreatment and Mapping – Medicare January 2016
CPT
CPT Description
APC
1
Facility Payment
Hospital
Ambulatory
Outpatient Surgery Center
Physician Payment
Physician
Physician
(Facility) 2 (Non-Facility) 3
See 2016 CPT Guide for full descriptions
E&M CODES – E&M codes will vary; consult your most recent CPT Coding Guide for E&M coding options and guidelines
4
PRE-PLANNING – MAPPING CODING
(See Coding Scenarios 1 and 2 following this section for Medicare “base case” coding examples for one and two doctor models)
Selective Catheterizations for Diagnostic Procedure
36246
36247
36248
NA
NA
NA
Selective catheter placement; initial second order and
; initial third order or more
; additional second order, third order and beyond
$00
$00
$00
$00
$00
$00
$282
$334
$52
$908
$1,607
$156
$2,718
$0
$00
$00
$57
$18
$151
$88
$9,542
$5,984
$517
$7,806
$0
$0
$0
$0
$115
$168
$115
$168
$0
$0
$0
$0
$10
$40
$23
$65
$112
$236
$236
$236
$62
$132
$132
$132
$61
$65
$72
$92
$150
$232
$264
$92
$332
$332
$332
$332
$332
$441
$441
$1,285
$1,285
$1,285
$0
$186
$186
$186
$186
$186
$246
$246
$718
$718
$718
$0
$21
$34
$25
$37
$34
$43
$53
$78
$96
$123
NA
$195
$220
$203
$249
$199
$339
$53
$78
$96
$123
$0
Hepatic Angiogram
75726
75774
5526 Angiography, visceral, radiological S&I
NA Angiography, selective, radiological S&I
Embolization (if indicated)
37242
5192 Arterial embolization or occlusion, inclusive of all
*
(J1 ) radiological S&I; arterial other than hemorrhage or tumor
Treatment Planning
5
77262
6
77263
NA
NA
Treatment Planning; intermediate OR
Treatment Planning; complex
3-D Post-Processing (for liver volume)
76376
76377
N
N
3D Post Scan, not requiring image post-processing
Cone Beam CT (Medicare NCCI edit with 78580)
CT Acquisition (may be billed in conjunction with CPT code 76377)
74150
74160
74170
74175
5570
5571
5571
5571
CTA without contrast material
CTA; with contrast material(s)
CTA; with and without contrast
CTA; abdomen & pelvis, with & without contrast
Imaging (coding options will vary based on provider preference)
78201
78205
78215
78580
78800
78802
78803
78811
78812
78816
6
A9540
5591
5591
5591
5591
5591
5592
5592
5594
5594
5594
N
Liver imaging, static
Liver imaging (SPECT)
Liver Spleen Imaging
Pulmonary perfusion imaging (Medicare NCCI edit 76377)
Radiopharmaceutical localization of tumor; limited area
Radiopharmaceutical localization whole body, single day
Radiopharmaceutical localization of tumor (SPECT)
Optional Procedure - PET; limited area
Optional Procedure - PET; skull base to mid-thigh
Optional Procedure - PET, whole body
Technetium TC-99m macro-aggregated albumin
1
Some CPT descriptors have been shortened for purposes of brevity. See your CPT Guide for full descriptors and coding guidelines.
“Facility payment” refers to professional services rendered in a facility setting such as hospital or ASC.
3
“Non-Facility payment” refers to professional services provided in the physician freestanding office, surgical or cancer center.
4
The possible coding options listed in this section are based on Medicare guidelines and society recommendations. Medicare base case
coding scenarios typical for one mapping and one treatment in the hospital outpatient or ASC setting follow this section.
5
Treatment planning should be billed and dictated separately prior to microspheres administration,
6
Do NOT code CPT 79445 for the injection of TC99 MAA on the mapping day as this is considered part of the nuclear medicine exam.
2
Page 4
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416.
Coding Options for SIR-Spheres® microspheres Therapy
Day of Treatment (Administration / Implant) – Medicare January 2016
CPT
APC
Shortened CPT Description1
See 2016 CPT Guide for full descriptions
Facility Payment
Hospital
Ambulatory
Outpatient Surgery Center
Physician Payment
Physician
Physician
(Facility)2
(Non-Facility)3
DAY OF TREATMENT CODING4
(See Coding Scenarios 1 and 2 following this section for Medicare “base case” coding examples for one and two doctor models)
Selective Catheterizations
36246
36247
36248
NA
NA
NA
Selective catheter placement; initial second order and
; initial third order or more
; additional second order, third order and beyond
$00
$00
$00
$00
$00
$00
$282
$334
$52
$908
$1,607
$156
$2,718
$0
$00
$00
$57
$18
$151
$88
$16,021
Private Payer
Contract price
$16,021
Private Payer
Contract Price
NA
NA
Hepatic Angiogram
75726
75774
5526 Angiography, visceral, radiological S&I
NA Angiography, selective, radiological S&I
Coding Options for Billing of Sources
(Yttrium-90 Microspheres – non stranded)
C2616
S2095
2616 Brachytherapy source (yttrium-90 non-stranded)
NA Transcatheter embo for tumor destruction using yttrium90 microspheres
Invoice
Private Payer
Microspheres Administration (See Coding Scenarios 1 and 2 for coding examples of One doctor and Two doctor model)
37243
77290
77300
7
77370
8
77470
9
77778
10
77790
79445
5192
(J1*)
5613
5611
5612
5623
5624
N
5661
Tumor embolization or occlusion, inc of all radiological
S&I; venous, for tumors, organ ischemia, or infarction
Simulation, Complex
Basic Dosimetry Calculation
Special Medical Radiation Physics Consultation
Special Treatment Procedure
Interstitial radiation source application; complex
Supervision, handling, loading of radiation source
Radiopharmaceutical therapy, by intra-arterial particulate
admin
$9,542
$5,984
$609
$9,912
$291
$107
$166
$505
$696
$0
$250
$163
$34
$93
$47
$367
$0
$139
$82
$33
$123
$109
$417
$15
$117
$520
$67
$123
$158
$789
$15
$117
$236
$236
$332
$332
$332
$332
$332
$441
$441
$1,285
$132
$132
$186
$186
$186
$186
$186
$246
$246
$718
$72
$92
$21
$34
$25
$37
$34
$43
$53
$123
$264
$92
$195
$220
$203
$249
$199
$339
$53
$123
Post Treatment Imaging (coding options will vary based on provider preference)
74170
74175
78201
78205
78215
78580
78800
78802
78803
78816
5571
5571
5591
5591
5591
5591
5591
5592
5592
5594
CTA; with and without contrast
CTA; abdomen & pelvis, with & without contrast
Liver imaging, static
Liver imaging (SPECT)
Liver Spleen Imaging
Pulmonary perfusion imaging (Medicare NCCI edit 76377)
Radiopharmaceutical localization of tumor; limited area
Radiopharmaceutical localization whole body, single day
Radiopharmaceutical localization of tumor (SPECT)
Optional Procedure - PET, whole body
7
Use of this code requires a written order by the physician.
Used in circumstances requiring extra work over and above basic dosimetry calculation: Patient with previous chemo, is receiving concurrent
chemo, or external beam radiation to the body/liver. AU must review current CT scan, liver function studies and ECOG performance status to
determinate % yttrium-90 dose to be adjusted taking into account previous treatments. Often used as a re-treatment code.
9
Medicare NCCI edit with 37243
10
Medicare packages this service with CPT 79445
8
Page 5
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416.
Coding Options for SIR-Spheres® microspheres Therapy
MEDICARE BASE CASE CODING SCENARIOS – FACILITY January 2016
The following coding examples are specific to Medicare base-case coding scenarios typical for one mapping and one treatment
in the hospital outpatient or ASC setting for both a one-doctor and a two-doctor model. Other procedures and imaging may be
performed. Society coding recommendations (SIR and ASTRO) vary and are not included in the example scenarios. Contact
Sirtex for additional information.
FACILITY CODING: SCENARIOS 1 AND 2
CPT
APC
CPT Description
Facility Payment
Hospital Outpatient Ambulatory Surgery
(OPPS)
Center (ASC)
PRE-PLANNING – MAPPING CODING
Selective Catheterizations for Diagnostic Procedure
36246
36247
36248
NA
NA
NA
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
$00
$00
$00
$00
$00
$00
$2,718
$00
$9,542
$5,984
$332
$332
$332
$0
$186
$186
$186
$0
$00
$00
$00
$00
$00
$00
$16,021
Private Payer
Contract Price
$16,021
Private Payer
Contract Price
$9,542
$5,984
Hepatic Angiogram
75726
5526 Angiography, visceral, radiological S&I
Embolization (if indicated)
37242
5192 Arterial embolization or occlusion, inclusive of all radiological S&I;
*
(J1 ) arterial other than hemorrhage or tumor
Imaging (coding options will vary based on provider preference)
78201
78205
78580
11
A9540
5591
5591
5591
N
Liver imaging, static OR
Liver imaging (SPECT)
Pulmonary perfusion imaging (Medicare NCCI edit 76377)
Technetium TC-99m macro-aggregated albumin
DAY OF TREATMENT CODING
Selective Catheterizations
36246
36247
36248
NA
NA
NA
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
Coding Options for Billing of Sources (Yttrium-90 Microspheres)
C2616
S2095
2616 Brachytherapy source (yttrium-90 non-stranded)
NA Transcatheter embo for tumor destruction using yttrium-90
microspheres
Microspheres Administration 12
37243
5192 Tumor embolization or occlusion, inc of all radiological S&I; venous, for
(J1*) tumors, organ ischemia, or infarction
7730012 5611 Basic Dosimetry Calculation
7944512 5661 Radiopharmaceutical therapy, by intra-arterial particulate admin
$107
$34
$250
$139
$332
$332
$186
$186
Post Treatment Imaging (coding options will vary based on provider preference)
78201
78205
5591 Liver imaging, static
5591 Liver imaging (SPECT)
11
Do NOT code CPT 79445 for the injection of TC99 MAA on the mapping day as this is considered part of the nuclear medicine exam.
CPT codes 77300 and 79445 will be packaged with payment for CPT 37243. CPT code 37243 is assigned to a Comprehensive APC (J1),
which means all services performed on the day of treatment will be packaged (CPT 37243 is always performed/billed on day of treatment).
12
Page 6
*Status Code J1: Comprehensive APC (C-APC). In 2015 CMS created C-APCs using Status Indicator J1. All associated services will be
packaged within the primary code (assigned as J1 status indicator). All pretreatment and mapping services will be packaged when billed on
the same day as CPT code 37242 (J1) or 37243 (J!) (with the exception of Yttrium-90 brachytherapy sources billed under C2616).
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416. -.
CPT Description
Facility Payment
Hospital Outpatient Ambulatory Surgery
(OPPS)
Center (ASC)
CPT
APC
74170
5571 CTA; with and without contrast
$236
$132
74175
5571 CTA; abdomen & pelvis, with & without contrast
$236
$132
Coding Options for SIR-Spheres® microspheres Therapy
MEDICARE BASE CASE CODING SCENARIOS – PHYSICIAN January 2016
The following coding examples are specific to Medicare base-case coding scenarios typical for one mapping and one treatment in the
hospital outpatient or ASC setting for a one-doctor model. Other procedures and imaging may be performed. Society coding
recommendations (SIR and ASTRO) vary and are not included in the example scenarios. Contact Sirtex for additional information.
PHYSICIAN CODING SCENARIO 1: ONE DOCTOR MODEL (PHYSICIAN ACTS AS BOTH IR AND AU)
Medicare 2016 Physician Payment
CPT
CPT Description
Physician (Facility)
Physician (Non-Facility)
$282
$334
$52
$908
$1,607
$156
$57
$18
$151
$88
$517
$7,806
$115
$168
$115
$168
$21
$34
$37
$195
$220
$249
$282
$334
$52
$609
$908
$1,607
$156
$9,912
PRE-PLANNING – MAPPING CODING
Selective Catheterizations for Diagnostic Procedure
36246
36247
36248
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
Hepatic Angiogram
75726
75774
Angiography, visceral, radiological S&I
Angiography, selective, radiological S&I
Embolization (if indicated)
37242
Arterial embolization or occlusion, inclusive of all radiological S&I; arterial
other than hemorrhage or tumor
Treatment Planning
13
77262
6
77263
Treatment Planning; intermediate OR
Treatment Planning; complex
Imaging (coding options will vary based on provider preference)
78201
78205
78580
Liver imaging, static OR
Liver imaging (SPECT)
Pulmonary perfusion imaging (Medicare NCCI edit 76377)
DAY OF TREATMENT CODING
36246
36247
36248
37243
13
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
Tumor embolization or occlusion, inclusive of all radiological S&I; venous, for
tumors, organ ischemia, or infarction
Treatment planning should be billed and dictated separately prior to microspheres administration.
Page 7
*Status Code J1: Comprehensive APC (C-APC). In 2015 CMS created C-APCs using Status Indicator J1. All associated services will be
packaged within the primary code (assigned as J1 status indicator). All pretreatment and mapping services will be packaged when billed on
the same day as CPT code 37242 (J1) or 37243 (J!) (with the exception of Yttrium-90 brachytherapy sources billed under C2616).
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416. -.
Medicare 2016 Physician Payment
CPT
77300
79445
CPT Description
Basic Dosimetry Calculation
Radiopharmaceutical therapy, by intra-arterial particulate admin
Physician (Facility)
Physician (Non-Facility)
$33
$117
$67
$117
$21
$34
$72
$92
$195
$220
$264
$92
Post Treatment Imaging (coding options will vary based on provider preference)
78201
78205
74170
74175
Liver imaging, static
Liver imaging (SPECT)
CTA; with and without contrast
CTA; abdomen & pelvis, with & without contrast
Page 8
*Status Code J1: Comprehensive APC (C-APC). In 2015 CMS created C-APCs using Status Indicator J1. All associated services will be
packaged within the primary code (assigned as J1 status indicator). All pretreatment and mapping services will be packaged when billed on
the same day as CPT code 37242 (J1) or 37243 (J!) (with the exception of Yttrium-90 brachytherapy sources billed under C2616).
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416. -.
Coding Options for SIR-Spheres® microspheres Therapy
MEDICARE BASE CASE CODING SCENARIOS – PHYSICIAN January 2016
The following coding examples are specific to Medicare base-case coding scenarios typical for one mapping and one treatment in the
hospital outpatient or ASC setting for a two-doctor model. Other procedures and imaging may be performed. Society coding
recommendations (SIR and ASTRO) vary and are not included in the example scenarios. Contact Sirtex for additional information.
PHYSICIAN CODING SCENARIO 2: TWO DOCTOR MODEL (TWO PHYSICIANS, IR AND SEPARATE AU)
Medicare 2016 Physician Payment
CPT
CPT Description
Physician (Facility)
Physician (Non-Facility)
$282
$334
$908
$1,607
$52
$156
$57
$18
$151
$88
$517
$7,806
$21
$34
$37
$195
$220
$249
$115
$168
$115
$168
$33
$117
$67
$117
$282
$334
$52
$609
$908
$1,607
$156
$9,912
$21
$34
$72
$92
$195
$220
$264
$92
PRE-PLANNING – MAPPING CODING
IR CODING
Selective Catheterizations for Diagnostic Procedure
36246
36247
36248
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
Hepatic Angiogram
75726
75774
Angiography, visceral, radiological S&I
Angiography, selective, radiological S&I
Embolization (if indicated)
37242
Arterial embolization or occlusion, inclusive of all radiological S&I; other than
hemorrhage or tumor
Imaging (coding options will vary based on provider preference)
Liver imaging, static OR
Liver imaging (SPECT)
Pulmonary perfusion imaging (Medicare NCCI edit 76377)
78201
78205
78580
AU CODING
14
77262
6
77263
Treatment Planning; intermediate OR
Treatment Planning; complex
DAY OF TREATMENT CODING
AU CODING
77300
79445
Basic Dosimetry Calculation
Radiopharmaceutical therapy, by intra-arterial particulate admin
IR CODING
36246
36247
36248
37243
Selective catheter placement; initial second order abdomen
; initial third order or more
; additional second order, third order and beyond
Tumor embolization or occlusion, inclusive of all radiological S&I; venous, for
tumors, organ ischemia, or infarction
Post Treatment Imaging (coding options will vary based on provider preference)
78201
78205
74170
74175
14
Liver imaging, static
Liver imaging (SPECT)
CTA; with and without contrast
CTA; abdomen & pelvis, with & without contrast
Treatment planning should be billed and dictated separately prior to microspheres administration,
Page 9
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. . 281-U-0416.
Coding Options for SIR-Spheres® microspheres Therapy
ICD 10 Diagnosis Code
Code primary cancer. The following diagnosis code range is specific to colorectal cancer (SIR-Spheres
microspheres is approved for colorectal cancer that has metastasized to the liver). If the cancer is other than
colorectal metastases, consult your ICD-10-CM code book for appropriated coding.
C18.0 – C18.9
C19.0 – C21.1
C78.7
Malignant neoplasm of colon
Malignant neoplasm of rectum
Secondary malignant neoplasm of liver and intrahepatic bile duct
MICROSPHERES REVENUE CODES
Revenue Code
0278
Descriptor
Medical / Surgical Supplies – Other Implants
Hospital Charge Master Reminder
• The hospital’s charge master should reflect the following codes for the microspheres
o C2616 (Brachytherapy source, yttrium-90 – non-stranded ) mapped to Revenue Code 0278 and/or
o S2095 (Trans-catheter occlusion or embolization for tumor destruction, percutaneous, any method,
using yttrium-90 microspheres: BC/BS)
• Coding of SIR-Spheres microspheres is dependent upon the patient’s health insurance coverage. Private
payer guidelines should be consulted for appropriate coding and payment.
NOTE:
It is important to consult with the hospital finance department to determine the appropriate charges for
0
the microspheres.
Page 10
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. . 281-U-0416.
877-642-7888
Page 11
This information is provided as a guide for coding services involving SIR-Spheres microspheres administration and is not intended to increase or maximize
reimbursement by any payer. We suggest consulting your third-party payer organizations with regard to local coverage, coding and reimbursement policies.
Providers assume full responsibility for all reimbursement decisions or actions. Current Procedural Terminology © 2015 American Medical Association. All
Rights Reserved. 281-U-0416