Billing and Coding: Radiopharmaceutical Agents (A55052) (2023)

General Information

Article Guidance

Article Text

Radiopharmaceutical Agents are isotopes, frequently attached to carrier molecules, used as adjuncts to
nuclear medicine diagnostic or therapeutic procedures. Reimbursement for these agents is based on the radiopharmaceutical only. This is the case whether they are obtained as a unit dose or from kit preparation.

The listing of the radiopharmaceutical agent and procedure code do not imply coverage. All of the procedure codes are subject to Medicare rules and regulations, applicable Local Coverage Determinations (LCDs), and medical necessity. The radiopharmaceutical agents may be subject to CCI (Corrective Coding Initiative) editing and hospital outpatient prospective payment system rules.

A.Technetium (Tc) labeled radiopharmaceuticals:

1.A9568-Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
Immunoscintigraphy, using single-photon emission computed tomography (SPECT) (CPT 78800-78804)

2.A9557-Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries
Brain imaging (CPT 78600 - 78606, 78610, 78803)

3.A9551-Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries
Parenchymal renal scan (CPT Codes 78700 - 78709, 78803)
Tumor detection (CPT 78800-78804)

4.A9539-Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
Lung ventilation (CPT 78579, 78580, 78582, 78597, 78598)
Testicular imaging with vascular flow (CPT 78761)
GFR renal scan (CPT 78700 – 78709, 78725, 78803)
Urinary bladder residual (CPT 78730)
Ureteral reflux (CPT 78740)
CSF study (CPT 78630 – 78645, 78650, 78803)
Brain study (CPT 78600- 78606, 78610,78803)
Shunt patency agent. 500 uCi (CPT 78291, 78645)
First-pass cardiac technique studies (CPT 78481, 78483)
Vascular flow study (CPT 78445)
Cardiac Shunt detection (78428)

5.A9567-Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
Lung ventilation (CPT 78579, 78580, 78582, 78597, 78598)

6.A9510-Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries
Hepatobiliary scan agent (CPT 78226, 78227)

7.A9521-Technetium tc-99m exametazine, diagnostic, per study dose, up to 25 millicuries
Brain perfusion (CPT 78600-78606, 78610, 78803)

8.A9569-Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
Infection detection (CPT 78000, 78803)

9.A4641-TechnetiumTc-99m human serum albumin, Radiopharmaceutical, diagnostic, not otherwise classified
CSF Leak Study (CPT 78630 – 78645, 78650, 78803)
Blood pool agent (CPT 78414-78458)
Lymphatic imaging (CPT 78195)

10.A4641-Technetium Tc-99m iminodiacetic Acid (IDA), Radiopharmaceutical, diagnostic, not otherwise classified
Hepatobiliary scan agent (CPT 78226, 78227)

11.A9540-Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuries
Lung perfusion agent (CPT 78580, 78582, 78597, 78598)
Peritoneal-Venous Shunt Study (CPT 78291)
Peritoneal cavity imaging prior to intraperitoneal chemotherapy (78800, 78801, 78803)
Cardiac Shunt Detection (CPT 78216, 78428)
Liver imaging (SPECT) (CPT 78201,78215, 78803)

12.A9537-Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries
Hepatobiliary scan agent (CPT 78226, 78227)

13.A9562 -Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries
Renal scan agent (CPT 78700 – 78709, 78725, 78803)

14.A9503-Technetium tc 99m, medronate, diagnostic, per study dose, up to 30 millicuries
Bone scan (CPT 78300-78315, 78399, 78803)

15.A9561-Technetium tc-99m Oxidronate, diagnostic, per study dose, up to 30 millicuries
Bone scan agent (CPT 78300-78315, 78399, 78803)

16.A9512-Technetium tc-99m-pertechnetate, diagnostic, per millicurie
Thyroid study (CPT 78012, 78013, 78014, 78015)
Brain death (CPT 78600- 78606, 78610, 78803)
First-pass cardiac technique studies (CPT 78481, 78483)
Meckel’s diverticulum 10-20 mCi (CPT 78261, 78290)
Parathyroid study (CPT 78070, 78071, 78072)
Parotid or salivary scan (CPT 78230-78232)
Gastric mucosa (CPT 78261, 78290)
Urinary bladder residual (CPT 78730)
Ureteral reflux study (CPT 78740)
Dacryocystography (CPT 78660)
Testicular imaging with vascular flow (CPT 78761)
Peritoneal-Venous Shunt Study (CPT 78291)
Cerebrospinal Fluid study (CPT 78630-78650)

17.A9538 -Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries
Bone/tumor (CPT 78300-78315,78803, 78999)
Myocardial Infarct imaging (78466-78469)

18.A9560-Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries
Cardiac blood pool imaging, gated Equilibrium studies (78472, 78473, 78494, 78496)
GI bleed study (CPT 78278)
Liver scan (for Hemangioma) (CPT 78201,78202 78803)
Vascular flow study (CPT 78445)
Venous thrombosis imaging (CPT 78457-78458)
Spleen imaging (CPT 78215, 78216, 78185)

19.A9500-Technetium tc-99m, sestamibi, diagnostic, per study dose
Cardiac perfusion (CPT 78451-78454)
Parathyroid study (CPT 78070, 78071, 78072)
Tumor (CPT 78605-78606, 78800-78804)
Breast tumor (CPT 78800, 78801)

20.A9541-Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries
Liver spleen scans (CPT 78201-78216)
Spleen scan (CPT 78185)
GI bleed studies (CPT 78278)
Bone marrow studies (CPT 78102-78104)
Gastric emptying, gastric emptying with colonic transit studies (CPT 78264, 78265, 78266)
Gastroesophageal reflux studies (CPT 78258, 78262)
Ureteral reflux study (CPT 78740)
Urinary bladder residual study (CPT 78730)
Lymphatics & Lymph glands (CPT 78195)
Peritoneal-pleural shunt studies (CPT 78291)

21.A9502-Technetium tc-99m tetrofosmin, diagnostic, per study dose
Myocardial perfusion studies (CPT 78451-78454)
Parathyroid study (CPT 78070, 78071, 78072, 78803)

22.A9520-Technetium tc-99m, tilmanocept, diagnostic, up to 0.5 millicuries
Lymphatics & Lymph glands (CPT 78195)

B.Iodine labeled radiopharmaceuticals:

1.I 123

a.A4641 Hippurate, Radiopharmaceutical, diagnostic, not otherwise classified
Renogram (CPT 78700 – 78709, 78725, 78803)

b.A9516-Iodine i-123 sodium iodide diagnostic, per 100 microcuries, up to 999 microcuries
Thyroid imaging (CPT 78012-78018, 78020, 78070, 78071, 78072)

c.A9509-Iodine i-123 sodium iodide, diagnostic, per millicurie
Thyroid imaging (CPT 78012-78018, 78020, 78070, 78071, 78072)

d.A9582-Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
Adrenal imaging/ Pheochromocytoma (CPT 78075)
neuroblastoma imaging. (78800-78804)

e. A9584-Iodine i-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
tomographic (SPECT),single area 78803

2.I 125

a.A9554-Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuries
Renogram (CPT 78707-78709, 78725)

b.A9532-Iodinated i-125 serum albumin, diagnostic, per 5 microcuries
Plasma Volume (CPT 78110-78111, 78122)

c.A9527-Iodine-i-125 sodium iodide solution, therapeutic, per millicurie
Hyperthyroidism or thyroid cancer (CPT 79005)
Intracavitary radiation source application, simple (77761)

3.I 131

a.A4641-Hippurate, Radiopharmaceutical, diagnostic, not otherwise classified
Renogram (CPT 78707-78709, 78725)

b.A9508 Iodine i-131 iobenguane sulfate per 0.5 millicurie
Adrenal imaging/ Pheochromocytoma (CPT 78075)
Neuroblastoma imaging. (78800-78804)

c.A9517-Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie
Hyperthyroidism or thyroid cancer (CPT 79005)

d.A9530-Iodine i-131 sodium iodide solution, therapeutic, per millicurie
Hyperthyroidism or thyroid cancer (CPT 79005)

e.A9528-Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie
Thyroid uptake and imaging (CPT 78012-78020, 78803)

f.A9529-Iodine i-131 sodium iodide solution, diagnostic, per millicurie
Thyroid uptake and imaging (CPT 78012-78020, 78803)

g.A9531-Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)
Thyroid uptake and imaging (CPT 78012-78020, 78803)

h.A9524-Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuries
Plasma Volume (CPT 78110-78111, 78122)
Brain imaging (CPT 78600-78606, 78610, 78803)
Pulmonary perfusion imaging (CPT 78580, 78582, 78597, 78598)
Cardiac imaging (CPT 78451-78454)
Tumor imaging (CPT 78800-78804)
Cardiac Blood Pooling imaging (CPT 78472-78473, 78481-78483)

C.Indium labeled Radiopharmaceuticals:

1.A9507-Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
Tumor detection (CPT 78800-78804)

2.A4641-Indium in 111 Diethylenetriamine Pentaacetic acid Radiopharmaceutical, diagnostic, not other wise specified
Cisternography or CSF leak detection, or shunt patency evaluation (CPT 78630 – 78645, 78650, 78803)
Gastric emptying (CPT 78264-78265)

3.A9548-Indium in-111 pentetate diagnostic, per 0.5 millicurie
Cisternogram (cerebrospinal fluid flow) (CPT 78630)
Cerebrospinal ventriculography (CPT 78635)
CSF Shunt evaluation (CPT 78645)
Cerebrospinal fluid scan (CPT 78803)
CSF Leakage detection and localization (CPT 78650)
Localization of tumor or distribution of radiopharmaceutical agent (78800)

4.A9547 -Indium-in-111 oxyquinoline, diagnostic, per 0.5 millicurie
Leukocyte labeling (CPT 78185,78800,78803)
Platelet labeling (CPT 78191, 78199)

5.A9572-Indium-in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Agent for localization of primary and metastatic neuroendocrine tumors bearing somatostatic receptors (CPT 78075, 78800-78804, 78015-78018)

6.A4642 Indium-in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
Agent for imaging colorectal or ovarian cancers (CPT 78800-78804)

7.A4641-Indium-IN-111 hydrochloride,-Radiopharmaceutical, diagnostic, not otherwise classified
Gastric emptying with colonic transit study (78264-78266)

8.A9570-Indium-in-111 labeled autologous white blood cells, diagnostic, per study dose
Leukocyte labeling (CPT78185, 78800,78803)

9.A9571-Indium in -111 labeled autologous platelets, diagnostic, per study dose
Platelet labeling (CPT 78191, 78199)

D.Miscellaneous Radiopharmaceuticals:

1. A9553-Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuries
RBC Mass (CPT 78120-78122)
RBC Survival (CPT 78130, 78140)
Platelet Survival (CPT 78191)

2. A9556- Gallium ga-67 citrate, diagnostic, per millicurie
Used in scans searching for infections, inflammation, tumors (CPT 78800 -78804, 78999)

3. A9564-Chromic Phosphate p-32, suspension, therapeutic, per millicurie
Therapeutic imaging agent for treatment of ovarian cancer (CPT 79200)
Interstitial radioactive colloid therapy (CPT 79300, 79445)

4 A9563-Sodium phosphate p-32, therapeutic, per millicurie
Therapeutic imaging agent for treatment of polycythemia vera or thrombocythemia (CPT 79101)

5. A9600-Strontium sr-89 chloride, therapeutic, per millicurie
Therapeutic for treatment of bone pain due to skeletal metastases. (CPT 79101)

6. A9604-Samarium sm-153 lexidronam, therapeutic, per treatment dose up to 150 millicuries
Therapeutic for the treatment of pain in patients with confirmed osteoblastic metastatic bone lesions that enhance on radionuclide bone scan (CPT 79101)

7. A9505-Thallous chloride tl-201, diagnostic, per millicurie
Cardiac imaging (CPT 78451-78454)
Parathyroid imaging (CPT 78070, 78071, 78072)
Tumor imaging (CPT 78800-78804)
Brain imaging (CPT 78803)

8. A9558-Xenon xe-133 gas, diagnostic, per 10 millicuries
Lung study (CPT 78579, 78580, 78582, 78597, 78598)

9. A9543-Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries

a. To report the radiopharmaceutical therapy using radiolabeled monoclonal antibodies for the treatment of non-Hodgkin's lymphoma use code 79403 and the therapeutic imaging agent, A9543-Yttrium y- 90 ibritumomab tiuxetan.

79403 Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion

This code includes the physician service, which includes counseling the patient and family, setting up and infusing the radiopharmaceutical and post-procedure time reviewing the appropriate blood work.

E. PET Scan radiopharmaceuticals:

1. A9555-Rubidium rb-82 diagnostic, per study dose up to 60 millicuries

2. A9552-Fluorodeoxyglucose f-18 fdg, diagnostic per study dose, up to 45 millicuries

3.A9526-Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuries

4.A9586-Florbetapir f-18, diagnostic, per study dose, up to 10 millicuries

5.Q9982 Flutemetamol f-18, diagnostic, per study dose, up to 5 millicuries

6.Q9983Florbetaben f-18, diagnostic, per study dose, up to 8.1 millicuries

7.A9515 Choline c-11, diagnostic, per study dose up to 20 millicuries

8.A9587 Gallium ga-68, dotatate, diagnostic, 0.1 millicurie

9.A9588Fluciclovine f-18, diagnostic, 1 millicurie

10. A9597 Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified

11.A9598Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified

12. A9592 Copper Cu 64 dotatate, diagnostic, 1 millicurie (Detectnet™)

13. A9591 "Fluoroestradiol f 18, diagnostic,1 millicurie (Cerianna™)

14. A9595 Piflufolastat F 18 diagnostic, 1 millicurie (Pylarify™)

15. A9593 Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie

16. A9594 Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie

17. A9596 Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie

18. A9601 Flortaucipir f 18 injection, diagnostic, 1 millicurie

F. The following agents are no longer marketed in the United States and will be denied. Coverage will be added if the agent(s) become available in the future.

1. A9501 Technetium tc-99m teboroxime diagnostic, per study dose

2. A9504 Technetium tc 99m apcitide, per study dose, up to 20 millicuries

3. A9536 Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries

4. A9550 Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicure

5. A9566 Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries

6. A9546 Cobalt co-57/58 cyanocobalamin, diagnostic, per study dose, up to 1 microcurie

7. A9559 Cobalt co-57 cyanocobalamin, diagnostic, per study dose, up to 1 microcurie

8. A9542 Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries

G.Use of radiopharmaceuticals is regulated by the Nuclear Regulatory Commission (NRC) under strict procedures and guidelines. Persons administering radiopharmaceuticals should have either a license from the NRC or be credentialed by an institution having a broad license from the NRC.

Documentation Requirements
The procedure note/medical record should document the findings supportive of the diagnosis stated on the claim. The record should also indicate the radiopharmaceutical name and amount administered and be made available to the Contractor upon request.

Utilization Guidelines
Data has shown incorrect coding /utilization for A9500 and A9502, A9503. These agents are to be billed once per study. Codes were being billed per mCi.

Up to 2 units of service will be allowed for A9500 and A9502.
One unit of service will be allowed for A9503.

Claims reviewed for cardiac blood pool imaging/gated Equilibrium studies (78472, 78473, 78494, and 78496) were submitted with incorrect radiopharmaceutical codes. A9560 will be allowed for these procedure codes. A9538 and A9512 will be denied when billed with these CPT codes.

1.The radiopharmaceutical and the procedure code should be billed on the same claim. If the procedure code and radiopharmaceutical are not billed on the same claim, it could result in payment delays or unnecessary denials. The injection of the radiopharmaceutical agent should only be billed when it is accompanied by the agent and the procedure.

2.The ordering and referring providers name and NPI (National Provider Identifier) must be on the claim.

-The referring physician's name and NPI must be indicated in 2310A or 2420F loop NM1 & REF segments for electronic media claims (EMC) or item 17 and 17B of the CMS 1500 form.

-The ordering provider’s name and NPI must be indicated in Loop 2420E (ordering) for EMC or item 17 and 17B of the CMS 1500 form.

3.Codes 78012-79999 can be billed with the modifiers -26 (Professional Component) and -TC.
In the inpatient and outpatient hospital setting- the technical (TC) portion is only payable when submitted by the hospital to MAC A.

Global and technical services are not payable by the MAC B in the inpatient and outpatient setting.

4.Similarly, agent codes (e.g., A4641, A4642, A9500-A9507, A9600) administered in an inpatient or outpatient hospital are billed by the hospital to MAC A.

5.78804 may only be reported once, no matter how many scans are reported. This code represents the administration of radiopharmaceutical and performance and interpretation of all scans.

6.Rituximab prior to the administration of Zevalin is separately payable.

7.Coding radiopharmaceuticals
Check the radiopharmaceuticals current HCPCS code description. The codes description defines one unit of service.

A.Most radiopharmaceuticals that have their own code include in the code’s description “per study dose” and include a range of mCi’s. These radiopharmaceutical agents should be billed as one unit of service per study. It is not appropriate to bill per mCi for the codes that include per study dose in its HCPCS description. It would be unusual to have more than 2 units of service for most of the agents with a per study dose or per treatment in its description.

Example: A9503 is defined as Technetium tc 99m, Medronate, (MDP), diagnostic, per study dose, up to 30 mCi’s). Per study dose, up to 30 millicuries is one unit of service. If the provider administers one to 30mCi of this agent for a study, it should be billed as one unit of service.

B.Some radiopharmaceutical code descriptions are defined as per millicurie (mCi). These agents should be billed per millicurie. The number of mCi’s that were administered to the patient should be the same as the number of services listed in the unit field on the claim.

Example: A9512 is defined as Technetium tc-99m-Pertechnetate, Diagnostic, per mCi. If you administer 5 mCi of this agent to your patient, then 5 would be listed in the units’ field of the claim.

C.NOC radiopharmaceutical codes (A4641, A9699) should be billed with one unit of service. The claim must include the name and total dosage of the agent in item 19 of the CMS 1500 form, or the electronic equivalent for EMC.

8.There are several kits that can be used for both myocardial infarct imaging and blood pool imaging tests. Examples of these kits include CIS-PRO, Technescan and Phosphotec. The kits are prepared/mixed differently depending on the test that is performed. The radiopharmaceutical code billed should correspond to the test performed.

9.Cardiac blood pool imaging,
There are two types of studies: first pass studies and equilibrium studies.

A. First pass Studies (CPT codes 78481 and 78483)
First pass studies utilize rapidly acquired images of a bolus of a radiopharmaceutical agent as it moves through the heart. The first pass technique only views the initial flow of the radiopharmaceutical as it moves through the heart.

78481 is a single first pass study at rest or stress, requiring a single injection. The radiopharmaceutical may be any product that has enough photons packed into the bolus to provide adequate counting statistics from which assessment and measurements of ejection fraction and wall motion can be derived.

78483 is a multiple first pass study at rest and stress, and requires two injections of appropriate radiopharmaceutical agent(s).

B. Gated Equilibrium studies (78472, 78473, 78494, and 78496).
Unlike the first pass technique, gated blood pool imaging studies are assessed over multiple cardiac cycles. This procedure involves binding /tagging the red blood cells with Technetium tc99m.

A9560 Technetium tc-99m Labeled Red Blood Cell’s (RBC’s), Diagnostic, per study dose, up to 30 mCi's,

A9560 is the radiopharmaceutical code that should be used for tagging red blood cells. It should be used for both the in vitro (Ultratag) and in vivo (non-radioactive “cold “pyrophosphate (PYP) followed by an injection of 99m technetium) methods. Regardless of the method used to tag the red blood cells, in vitro or in vivo, the correct code to use is A9560.

In vitro-whole blood is withdrawn from the patient and transferred to a sterile UltraTag bag or vial. Tc 99m Pertechnetate is added to the bag or vial and incubated at room temperature for approximately 25 minutes. The patient is then injected with labeled RBCs.

In vivo- Pt is injected with “non-radioactive” “cold” Pyrophosphate (PYP) reconstituted with normal saline followed 20 minutes later by an injection of Tc 99m Pertechnetate.

Note: Pertechnetate is a commonly used radiopharmaceutical given during a nuclear scan to allow imaging with specialized equipment. The cost for the pertechnetate, in this instance, is considered part of the payment for A9560 and thus not separately payable. The individual components of preparing tagged red blood cells will not be paid for separately. A9512 will not be paid when billed with A9560.

10.Myocardial Infarct Imaging - CPT codes 78466-78469.
A9538 Technetium tc-99m pyrophosphate, diagnostic, per study dose up to 25 mCi's is used for these procedures. This code is used for Pyrophosphate (PYP) compounded /prepared with technetium tc-99m pertechnetate. It is prepared external to the patient and is then administered intravenously for cardiac “hot spot” imaging.

Do not use HCPCS A9538 when administering "non-radioactive" Pyrophosphate with saline followed by a second administration of Tc99m pertechnetate. A9512 will not be paid separately when billed with A9538. Invoices will not be necessary for reimbursement of A9538.

11.Myocardial Perfusion imaging studies (78451-78454)
Radiopharmaceuticals commonly used for these studies include A9500 and A9502.
A9500Technetium tc-99m, Sestamibi, diagnostic, per study dose,
A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose

If two (2) per study doses of these agents are used, one for rest and one for the stress portion of the study, it would be billed as two (2) units.

Example: A9500 is defined as Technetium tc-99m sestamibi, diagnostic, per study dose. When multiple studies (rest and stress) nuclear medicine procedures are performed using this agent for two studies it would be appropriate to bill for 2 units.

12.Electronic submitters should indicate they have additional documentation or an invoice, which Medicare may require, by indicating “DOCUMENTATION AVAILABLE UPON REQUEST” in the electronic equivalent of item 19. If the additional documentation or an invoice you have is needed for Medicare to make its payment determination, a development letter will be sent requesting the information. If you do not indicate the availability of the additional documentation, or the information is not returned timely, the claim will be returned as unprocessable.

13Invoices must clearly indicate the name of the radiopharmaceutical and the dosage billed must correspond to the HCPC’s code description.

a.HCPC’s descriptions with a specified unit of measure such as mCi:

A9512 is defined as Technetium tc-99m-Pertechnetate, Diagnostic, per mCi. The invoice must indicate the number of mCi in a dose. The number of mCi’s would match the number of units billed on the claim. If the invoice lists a dose price, you must indicate the number of mCi’s in the dose. This can be added to the manufacturer’s invoice and must be signed or initialed to indicate information was added.

b.HCPC’s descriptions that state per study dose, up to a specified number of millicuries:

A9539 Technetium tc-99m Pentetate, Diagnostic, per study dose, up to 25 mCi's,
Per study dose, up to 25 millicuries is one unit of service. If the provider administers one to 25mCi of this agent for a study, it should be billed as one unit of service. The invoice should indicate the cost of the radiopharmaceutical dosage given for the study.

14.A9547 Indium-in-111 Oxyquinoline, will not be paid when billed with A9570 Indium-111 labeled autologous white blood cells, or A9571 Indium in-111 labeled autologous platelets.

A9547 Indium-in-111 Oxyquinoline, Diagnostic, per 0.5 mCi,
Leukocyte labeling (CPT 78185, 78800, 78803)
Platelet labeling. (CPT 78191, 78199)

A9570 Indium-in-111 labeled autologous white blood cells, diagnostic, per study dose
Leukocyte labeling (CPT 78185, 78800, 78803)

A9571 Indium in-111 labeled autologous platelets, diagnostic, per study dose (A9571)
Platelet labeling. (CPT 78191, 78199)