How To Use HCPCS Code A9555

HCPCS code A9555 describes the diagnostic use of Rubidium rb-82, per study dose, up to 60 millicuries. This code is used to identify the administration of Rubidium rb-82 for diagnostic purposes in radiology. In this article, we will explore the details of HCPCS code A9555, 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 A9555?

HCPCS code A9555 is used to identify the diagnostic use of Rubidium rb-82, per study dose, up to 60 millicuries. This code specifically refers to the administration of Rubidium rb-82 for diagnostic radiology purposes. It is important to note that this code is not applicable for therapeutic use or any other procedures not related to diagnostic radiology.

2. Official Description

The official description of HCPCS code A9555 is “Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries.” The short description for this code is “Rb82 rubidium.”

3. Procedure

1. The procedure for HCPCS code A9555 involves the administration of Rubidium rb-82 to the patient for diagnostic radiology purposes.
2. The healthcare provider will prepare the necessary equipment and ensure the proper dosage of Rubidium rb-82.
3. The provider will then administer the Rubidium rb-82 to the patient, following the appropriate safety protocols and guidelines.
4. After the administration, the patient may undergo imaging or other diagnostic tests to evaluate the specific condition or area of interest.
5. The results of the diagnostic tests will help the healthcare provider make an accurate diagnosis and determine the appropriate course of treatment.

4. When to use HCPCS code A9555

HCPCS code A9555 should be used when a healthcare provider administers Rubidium rb-82 for diagnostic radiology purposes. This code is specifically for the use of Rubidium rb-82 and should not be used for any other radiopharmaceuticals or procedures. It is important to ensure that the administration of Rubidium rb-82 is medically necessary and meets the criteria for diagnostic radiology.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9555, healthcare providers need to document the administration of Rubidium rb-82 for diagnostic radiology purposes. This documentation should include the dosage administered, the date of administration, and any relevant patient information. It is important to follow the specific billing guidelines provided by Medicare or other insurance carriers to ensure accurate reimbursement for the service.

6. Historical Information and Code Maintenance

HCPCS code A9555 was added to the Healthcare Common Procedure Coding System on January 01, 2006. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has a pricing indicator code of 99, which indicates that the value for reimbursement has not been established. It is important to stay updated with any changes or revisions to HCPCS code A9555 to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code A9555 may vary. It is important to check with the specific insurance carrier or Medicare guidelines to determine if this code is payable. The pricing indicator code for this code is 99, indicating that the value for reimbursement has not been established. It is essential to follow the guidelines provided by Medicare or other insurance carriers to ensure accurate reimbursement for the service.

8. Examples

Here are five examples of when HCPCS code A9555 should be billed:

1. A patient undergoes a cardiac stress test using Rubidium rb-82 for diagnostic purposes.
2. A physician orders a PET scan with Rubidium rb-82 to evaluate a patient’s brain function.
3. A radiologist administers Rubidium rb-82 to a patient for a myocardial perfusion imaging study.
4. A cardiologist uses Rubidium rb-82 to assess the blood flow in a patient’s coronary arteries.
5. A nuclear medicine technologist administers Rubidium rb-82 for a diagnostic study of a patient’s lung function.