How To Use HCPCS Code A9517

HCPCS code A9517 describes the use of iodine i-131 sodium iodide capsules for therapeutic purposes. This code is used to identify the administration of radioactive iodine to treat certain medical conditions. In this article, we will explore the details of HCPCS code A9517, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A9517?

HCPCS code A9517 is used to identify the administration of iodine i-131 sodium iodide capsules for therapeutic purposes. This radioactive iodine treatment is commonly used in the management of thyroid disorders, such as hyperthyroidism and thyroid cancer. It is important to note that this code specifically refers to the therapeutic use of iodine i-131 sodium iodide capsules and not for diagnostic purposes.

2. Official Description

The official description of HCPCS code A9517 is “Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurie.” The short description for this code is “I131 iodide cap, rx.” This description accurately reflects the purpose of this code, which is to identify the administration of therapeutic radioactive iodine capsules.

3. Procedure

1. The procedure for HCPCS code A9517 involves the administration of iodine i-131 sodium iodide capsules to the patient.
2. The capsules are typically taken orally, following specific instructions provided by the healthcare provider.
3. The dosage of the capsules is measured in millicuries, which determines the amount of radioactive iodine administered to the patient.
4. It is crucial for the healthcare provider to follow proper radiation safety protocols during the administration of this treatment.
5. After the administration, the patient may be required to follow certain precautions, such as limiting close contact with others, due to the potential radiation exposure.

4. When to use HCPCS code A9517

HCPCS code A9517 should be used when a healthcare provider administers iodine i-131 sodium iodide capsules for therapeutic purposes. This treatment is typically used in cases of hyperthyroidism, thyroid cancer, or other thyroid disorders that require the use of radioactive iodine to destroy or control abnormal thyroid tissue. It is important to review the specific guidelines and indications for the use of this treatment to ensure accurate coding.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9517, healthcare providers need to document the administration of iodine i-131 sodium iodide capsules for therapeutic purposes. The documentation should include the dosage administered in millicuries and any relevant information regarding the patient’s condition and treatment plan. It is essential to follow the specific billing guidelines provided by the payer to ensure proper reimbursement for this service.

6. Historical Information and Code Maintenance

HCPCS code A9517 was added to the Healthcare Common Procedure Coding System on January 01, 2003. It has an effective date of January 01, 2006. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition. It is important for medical coders to stay updated with any changes or revisions to HCPCS codes to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

The coverage of HCPCS code A9517 may vary depending on the payer. Medicare and other insurance providers may cover the administration of iodine i-131 sodium iodide capsules for therapeutic purposes under certain circumstances. The pricing indicator code 57 indicates that the pricing for this code is determined by other carriers. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. It is crucial to verify the coverage and reimbursement policies of the specific payer before submitting claims for this service.

8. Examples

Here are five examples of when HCPCS code A9517 should be billed:

1. A patient with hyperthyroidism receives a therapeutic dose of iodine i-131 sodium iodide capsules to control the overactive thyroid gland.
2. A patient with thyroid cancer undergoes radioactive iodine treatment to destroy any remaining cancer cells after surgery.
3. A patient with a recurrent thyroid nodule receives iodine i-131 sodium iodide capsules to shrink or eliminate the abnormal tissue.
4. A patient with Graves’ disease undergoes radioactive iodine therapy to reduce the production of thyroid hormones.
5. A patient with thyroid hormone resistance syndrome receives iodine i-131 sodium iodide capsules to manage the symptoms and regulate thyroid function.