Practice Management

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  • 1.  PET CT Axumin

    Posted 10-09-2018 19:02
    Hello Forum,

    We have a client that is considering adding PET CT Axumin scans for men with suspected prostate cancer at their imaging center. 

    Is anyone else performing these scans using Axumin?  The PET CT codes are the same 78815 or 78816, but the radiopharmaceutical code is A9588.

    Are you being paid for these studies and the radiopharmaceutical?

    Feel free to contact me offline.


    ------------------------------
    Cindy Pittmon RCC, CHBME, FRBMA
    President, CEO
    Acclaim Radiology Management
    Longview TX
    (903) 663-4800
    ------------------------------


  • 2.  RE: PET CT Axumin

    Posted 10-09-2018 19:03

    We are but have not done one yet.  Our plan is to get them prior authorized.

     

    Ruby O'Brochta-Woodward BSN, CPC, CPB, CPMA, COSC, CSFAC, CPC-I

    Suburban Radiologic Consultants

    Coding & Compliance Manager

    952-837-9791 Office

    952-837-9701 Fax

    952-210-4847 Cell

     

    SI Sig

     

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    Original Message


  • 3.  RE: PET CT Axumin

    Posted 10-09-2018 19:50

    Any feedback on this would be great – we are also interested in starting this as well in our facility.

     

    Diane Ramirez

    Business Manager

    3226 S Alameda St

    Corpus Christi, TX 78404

    361-853-4503 ext 1006

    361-389-8014 - Cell Phone

     

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    Original Message


  • 4.  RE: PET CT Axumin

    Posted 10-10-2018 18:54
    ​Hello,

    Yes, we are currently doing this study, however, only Medicare is reimbursing for the study.

    Hope this is helpful,

    Lisa Ford

    ------------------------------
    Lisa Ford
    Marketing Representative
    Desert Medical Imaging, LLC
    Indian Wells CA
    (760) 776-8989
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    Original Message


  • 5.  RE: PET CT Axumin

    Posted 10-11-2018 08:12
    ​Hello,

    We are being asked to provide this service also. We are hesitant to move forward given the cost of the radiopharmaceutical.  

    For those providing this service, are you imaging Medicare patients only? Are you passing on the cost not covered by Medicare? Do you plan to continue the service once the pass-through period is eliminated? Also, anyone in NY doing these studies?

    Thank you!
    Haley

    ------------------------------
    Haley Maxson
    Administrator
    Park Avenue Radiologists, PC
    Johnson City NY
    (607) 729-2125
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    Original Message


  • 6.  RE: PET CT Axumin

    Posted 10-26-2018 18:08
    Oregon Imaging, Eugene, OR, has had VERY FEW problems with Axumin on most payors - no issue with CMS or Mgd Medicare payors. 

    Here is a list of payors we've had success with on over 100 cases.   Getting the number of services correct payor by payor was the initial issue and now Medicare wants NOS of "1" but want the number of "units" also reflected on the HCFA claim form (typically 9-10 units).  Be sure to bill for unused amounts, CMS is paying for that also (QW modifier??  I think!)

    Prior auth is the key of course for those payors that require it, but for the most part, other than monitoring payments to at least cover our costs, we getting a high hit rate on payment - don't look to see a spike in cash for Axumin though.  Still, great press from our referring physician base.

    Call me with more questions, but so far so good.

    Dennis Chaltraw, OR Imaging/Radiology Associates, 541-302-7771, thanks!

    AARP - SECURE HORIZONS UHC
    BLUE CROSS OREGON
    EBMS - EMPLOYEE BENEFIT MGMT
    HEALTH NET
    HEALTH NET MED OPTIONS
    MEDICARE PART B
    MEDICARE PART B MSP
    MERITAIN HEALTH
    PACIFICSOURCE
    PROVIDENCE HEALTH PLAN
    PROVIDENCE MEDICARE
    PROVIDENCE PREFERRED PLUS
    REGENCE MED ADVANTAGE
    SAMARITAN MED ADVANTAGE
    UNITED HEALTHCARE RR MEDICARE
    WPC-VAPC3


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    Dennis Chaltraw
    Director, Revenue Cycle Management
    Oregon Imaging Centers
    Eugene OR
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    Original Message


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