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New radiopharmaceutical receives CMS billing code

by Loren Bonner, DOTmed News Online Editor | August 27, 2013
A new radioactive diagnostic imaging agent used to help doctors with the staging and management of breast and melanoma cancer patients has just been issued pass-through "C" coding.

According to Navidea Biopharmaceuticals, Inc., the company that makes the agent, the coding will streamline the billing and reimbursement process for hospital providers who use the agent and support its fair and equitable reimbursement.

The new drug, technetium Tc 99m tilmanocept (Lymphoseek), was approved by the U.S. Food and Drug Administration in March. According to experts, it will give doctors a more accurate way to find the sentinel lymph node, and in turn, help them determine where the patient's cancer has spread.
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The arrival of Lymphoseek is a testament to the advancements in molecular imaging that have taken place in the past 10 to 15 years. In contrast to previous lymph node mapping agents, Lymphoseek is a receptor-based agent that targets receptors on the surface of the lymphatic cells.

The new billing code will become effective on October 1, 2013.

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