Radiation Risk
Diagnostic radiopharmaceuticals, including Detectnet, contribute to a patient s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling and preparation procedures to protect patients and health care workers from unintentional radiation exposure. Advise patients to hydrate before and after administration and to void frequently after administration.
Risk for Image Misinterpretation
The uptake of copper Cu 64 dotatate reflects the level of somatostatin receptor density in NETs, however, uptake can also be seen in a variety of other tumors that also express somatostatin receptors. Increased uptake might also be seen in other non-cancerous pathologic conditions that express somatostatin receptors including thyroid disease or in subacute inflammation, or might occur as a normal physiologic variant (e.g. uncinate process of the pancreas).
RadioMedix & Curium Announce Permanent HCPCS Code for DetectnetTM (copper Cu 64 dotatate injection)
St. Louis, MO, Jan. 26, 2021 (GLOBE NEWSWIRE) RadioMedix Inc. and its commercial partner Curium announced today that the Centers for Medicare & Medicaid Services (CMS) has granted Detectnet a permanent Healthcare Common Procedure Coding System (HCPCS) code – A9592 – effective April 1, 2021. The descriptor for this product specific A code will be: Copper Cu-64, dotatate, diagnostic, 1 millicurie. Beginning on April 1, 2021, this code will be available to bill claims for Medicare patients in non-hospital imaging centers and for private insurance patients in all imaging facilities. This information follows the recent news that Detectnet was granted Transitional Pass-Through Status by CMS (C9068) effective January 1, 2021. C9068 is used to bill Detectnet for Medicare patients seen in the hospital outpatient department.
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As we begin the new year, we wanted to highlight two final developments from December 2020:
First, on Dec. 27, 2020, the stimulus legislation H.R. 133, the Consolidated Appropriations Act of 2021 (link), Pub. L. 116‑260 (Act), was signed into law. The Act includes several changes relevant to government price reporting. Some of the provisions were first introduced as part of S. 2543, the Prescription Drug Pricing Reduction Act of 2019 (link) (PDPRA) – the bipartisan drug pricing bill that was passed by the Senate Finance Committee in September 2019, but that was never voted upon by the Senate.
Highlights
The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2021 Final Rule for the Medicare Physician Fee Schedule (MPFS), which contains updates to the Quality Payment Program (QPP). The MPFS dictates Medicare rates and policies under Part B, while the QPP implements two value-based payment programs: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
Among notable changes, CMS has proposed to make permanent certain telehealth changes that have been implemented in response to the COVID-19 public health emergency (PHE), confirmed the evaluation and management (E/M) documentation guidelines and payment changes finalized in the 2020 MPFS, and delayed the MIPS Value Pathway (MVP) until the 2022 performance period or later.