Coding Question:

An ASTRO member attended the 2004 ASTRO Socioeconomic Lunch and has the following question:

For prostate seed implants, the member typically orders six extra seeds in addition to the preplan count. There was an ACR Bulletin back in December 2001 that said, "Therefore, it is valid that the hospital charge the 'ordered seed' inventory for each patient, accounting for the seeds ordered only once." Is that still true? Should they bill for the number of seeds ordered or the number of seeds implanted in 2005?

CUAC Response:

ASTRO's Code Utilization and Application Committee is not aware of anything that has changed in 2005 on this issue. It is presumed in the ACR statement on the seed inventory, that these extra seeds are either used, returned, or wasted -- never transferred to another patient. Thus, it is appropriate for all seeds to be charged for, not just the ones that the doctor uses.

The opinions referenced are those of members of the ASTRO Code Utilization and Application Committee based on their coding experience and they are provided, without charge, as a service to the profession. They are based on the commonly used codes in radiation oncology, which are not all inclusive. Always check with your local insurance carriers, as policies vary by region. The final decision for coding for any procedure must be made by the physician, considering regulations of insurance carriers and any local, state or federal laws that apply to the physicians practice. ASTRO nor any of its officers, directors, agents, employees, committee members or other representatives shall have any liability for any claim, whether founded or unfounded, of any kind whatsoever, including but not limited to any claim for costs and legal fees, arising from the use of these opinions.

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