| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
C2645 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Brachytherapy planar source, palladium-103, per square millimeter |
| HCPCS Short Description |
Brachytx planar, p-103 |
| HCPCS Pricing Indicator Code 1 |
53 - Statute |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Statute Number |
1833(T) |
| HCPCS Coverage Code |
D - Special coverage instructions apply |
| HCPCS ASC Payment Group Code |
YY |
| HCPCS ASC Payment Group Effective Date |
1/1/2016 |
| HCPCS Berenson-Eggers Type Of Service Code |
I4B - Imaging/procedure - other |
| HCPCS Type Of Service Code 1 |
9 - Other medical items or services |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2016 |
| HCPCS Action Effective Date |
1/1/2016 |
| HCPCS Action Code |
N - No maintenance for this code |