CQW Panacea-re-brand-rev3

For the Week of August 31, 2015

Question:

What is the code for Isovue®-370? I have Q9967 but it shows up in the Medicare physician fee schedule (MPFS) as excluded with no payment.

Answer:

Q9967 (low osmolar contrast material, 300–399 mg/ml iodine concentration, per ml) is correct for Isovue®-370.

Drugs with HCPCS level II codes are not included in the MPFS. To find the payment amounts, you must look them up in the 2015 Medicare average sales price (ASP) drug files at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-Drugs/McrPartBDrugAvgSalesPrice/2015ASPFiles.html. The fees for unlisted codes are included in the not otherwise classified (NOC) When you don’t know what the HCPCS code for a particular drug is, you can check the ASP national drug code (NDC)-HCPCS crosswalk.

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