Information Regarding Your Bill We support the right of patients to be fully informed, not only about their medical care, but also about the costs of care and how it is billed. Please keep these things in mind: Your medical team plans your seed implant procedure on days when you are not present; therefore charges may appear on your bill for a date of service in which you were not in our facility. Our charges include not only physician services, but also work done by our nurses, technicians, medical physics personnel, and others working "behind the scenes." Amounts authorized by Medicare do not always reflect the related costs accurately. Please feel free to call us with any questions about billing matters. We thought it would be helpful to describe most of our billing codes for you. Here is what is meant by: OFFICE CONSULTATION- 99243/99244/99245 When one physician sends a patient to another for consultation, the consulting doctor uses one of these codes. This may happen when our radiation oncologist sees a patient who has been sent by a urologist or primary care physician. NEW PATIENT OFFICE EXAM- 99203/99204/99205 A physician uses these codes for the first visit of a new patient. The length and complexity of the office visit determines which of the three codes is used. OFFICE VISIT- 92212 This charge is normally billed for volume study patients. On this visit, only a nurse and/or ultrasound technician may see you. Your radiation oncologist will review all results from this visit. PROSTATE VOLUME STUDY- 76873 Transrectal ultrasound to provide prostate measurements used for the treatment planning of your implant. CATHETERIZATION-53670 Prep and insertion of catheter for volume study and implant. SURGICAL TRAY-A4550 Supplies used in the operating room. TREATMENT DEVICE (SIMPLE)-77332 Covers the use of the special template to guide the needles in the implant. FLUOROSCOPY-76000 Use of fluoroscopy during the implant procedure, to aid the seed placement. ULTRASOUND GUIDANCE FOR INTERSTITIAL IMPLANT-76965 Physician's use of the ultrasound to guide the insertion of needles. TRANSPERINEAL PLACEMENT OF NEEDLES-55859 Urologist's professional charge for needle placement. INTERSTITIAL RADIOELEMENT APPLICATION (COMPLEX)-77290 Radiation Oncologist's professional charge for seed placement. SPECIAL TREATMENT PROCEDURE-77470 Covers the time and effort of the physician and the technical staff to plan for the optimal implant, due to the complexity of brachytherapy as a form of treatment. SIMULATION AIDED FIELD SETTING (COMPLEX)-77290 Verification of seed placement using AP and lateral (x-ray) films post-implant. SUPPLIES/NEEDLES-99070 Cost of medical supplies and needles used during your procedure. RADIOPHARMACEUTICAL-79900 Cost of radioactive "seeds" used in your procedure. ULTRASOUND-PELVIC-76857 Use of ultrasound to verify urinary retention after implant. CYSTOURETHROSCOPY FOR RETREIVAL OF FOREIGN BODY-52310 Urologist's professional charge for seed or spacer retrieval placed outside the prostate. ELECTROCARDIOGRAM (EKG)-93005 Required pre-operative testing for implant. CHEST X-RAY PA AND LATERAL VIEWS-71020 Required pre-operative testing. Blood drawn at the Outpatient Laboratory will be sent to Eisenhower Medical Center's Pathology Department for results. Patient will be billed for lab processing fee from Eisenhower Medical Center. THERAPEUTIC RADIOLOGY TREATMENT (COMPLEX) 77263 This code covers work normally done when you are not present at the center. This is used to record the physician's time in planning your entire course of treatment, including reviewing medical records and the results of your examination and lab tests, and evaluating the prescription to use for your implant. 3-D TREATMENT PLANNING-77295 This code covers work normally done when you are not present at the center. Development of a detailed seed implant plan, including a 3-D diagram and radiation dose calculation of how the seeds are to be distributed, and to assure that the physician's prescription for radiation treatment is appropriately filled. Number of seeds and needles are calculated and defined. PHYSICS QUALITY AND ASSURANCE-77336 This code covers work normally done when you are not present at the center. Medical physics charges for required quality assurance and radiation safety procedures. BASIC RADIATION DOSIMETRY CALCULATIONS-77300 This code covers work normally done when you are not present in the center. Isodose calculations are performed on your isotopes to verify the radiation dosage. SUPERVISION, HANDLING & LOADING OF RADIOELEMENT-77790 Handling of the radioactive seeds in preparation for your implant, including seed sterilization, loading seeds into needles, required documentation, etc. ANESTHESIA EXTRAPERITONEAL PROCEDURE LOWER ABDOMEN -00860 Anesthesiologist's professional charge. FACILITY FEE-55859T Facility charges, such as use of operating room and recovery room. Supplies not covered in surgical tray. Anesthesia supplies and pharmaceuticals. Nursing time. MEASUREMENT OF POST-VOIDING RESIDUAL URINE BY ULTRASOUND - 51798 Use of ultrasound to measure residual volume in the bladder post voiding and bladder capacity following seed implant. CT POST DOSIMETRY - 77014 CT scan scheduled following your seed implant to verify seed positions. Images are used for "post treatment" plan verification. BRACHYTHERAPY ISODOSE CALCULATION (COMPLEX)-77328 This code covers work normally done when you are not present at the center. When we receive your post-implant CT Scan, this code is used to prepare a "Post-Treatment" plan for verification. Including seed position with a diagram of how the seeds were distributed, and to assure that the physician's prescription for radiation treatment was appropriately filled. OFFICE/OUTPATIENT EXAM-99212 Follow-up visits, in the months or years after the patient has received treatment. Seed Implant Steps Consultation Prostate Volume Study Seed Implants Guidelines & Followup Information Regarding Your Bill Prostate Volume Study Instructions Clear Liquid Diet Instructions Other Treatment Options

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