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Review of Outpatient Brachytherapy Medicare Payments to Lakewood Ranch Medical Center

Lakewood Ranch Medical Center (Lakewood) met applicable Medicare payment requirements for all 43 claims for catheter insertion, Iodine-125 seeds, and Technetium-99m sources. However, none of the 65 SIR-Sphere claims met applicable Medicare payment requirements, resulting in overpayments of $762,000. Lakewood improperly billed these claims because it did not have policies and procedures to account for partial vial usage or handling, tracking, or proper disposition of the unused portion of a vial, and it did not follow its procedures for ordering brachytherapy sources.

Filed under: Center for Medicare and Medicaid Services