CPT 2005 deleted codes 78990 and 79900, provision of diagnostic and therapeutic radiopharmaceuticals. The question is: how will providers bill for RPs starting January 1, 2005?

In 2005, CMS published 70 HCPCS Level II codes which describe many of the available radiopharmaceuticals. Two of these codes are not otherwise classified (NOC) radiopharmaceutical codes, one each for diagnostic and therapeutic RPs. These NOC codes can be used when no specific radiopharmaceuticals code is available.

With the exception of the C series HCPCS Level II codes, (which are exclusively for the hospital out patient prospective payment system), we expect most third party payers will accept the A and Q HCPCS Level II code in place of the deleted CPT 78990 and CPT 79900 codes. We encourage you to work with your payers to choose the proper HCPCS Level II supply codes for your radiopharmaceuticals.

To assist you, the Society of Nuclear Medicine (SNM) has both hospital and physician office coding and reimbursement educational materials on its web site under the Practice Management section to assist you. www.snm.org