Hospital Billing Alert: Claims without a Radiopharmaceutical Will Be Returned

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Effective January 1, 2008, CMS implemented an Outpatient Code Edit (OCE) that will result in the return of (for correction) any claim for a nuclear medicine procedure that does not contain a HCPCS Level II radiopharmaceutical code. The HCPCS code for billing FDG is A9552.

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