Lymphoseek will likely get A-code radiopharmaceutical reimbursement. Private payers still pay for A-code's. Granted, medicare recently only started paying bundles exam type only in the name of health care reform. That said, sulfur colloid doesn't have a designated specific A-code reimbursement.
I believe medicare only pays A-code to I-123 and or I-131 radiopharmaceuticals. I don't think lymphoseek will be an exception to this medicare rule, but will have to find out.
The financial aspect depends on your medicare vs private payer population. You could probably recoup approx. $340 reimbursement of that $200 lymphoseek price tag on lymphoseek with the likely A-code private payer reimbursement.
"My Nuclear Medicine dept head says they won't do anything that loses money. The max she would pay is $175-200/dose and that's if the head of the dept of surgery screamed at her nonstop for an hour. "
This statement seems to run contrary to P&T committee statement in earlier statement. Does your facility require the P&T committee approval? It has been my experience that I have never needed that approval.
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