How To Use HCPCS Code A9557

HCPCS code A9557 describes the use of Technetium tc-99m bicisate for diagnostic purposes. This code is used to identify the per study dose of up to 25 millicuries of Technetium tc-99m bicisate. In this article, we will explore the details of HCPCS code A9557, 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 A9557?

HCPCS code A9557 is used to identify the per study dose of Technetium tc-99m bicisate, a diagnostic radiology procedure. This code is specifically used for diagnostic purposes and is not applicable for therapeutic or treatment procedures. It is important to use this code accurately to ensure proper reimbursement and documentation.

2. Official Description

The official description of HCPCS code A9557 is “Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries”. The short description for this code is “Tc99m bicisate”. These descriptions accurately reflect the purpose and dosage of the procedure.

3. Procedure

1. The procedure for HCPCS code A9557 involves the administration of Technetium tc-99m bicisate to the patient.
2. The dosage should not exceed 25 millicuries per study.
3. The administration of Technetium tc-99m bicisate should be performed according to established protocols and guidelines.
4. Proper documentation of the procedure, including the dosage administered, should be recorded for billing and reimbursement purposes.

4. When to use HCPCS code A9557

HCPCS code A9557 should be used when performing a diagnostic study using Technetium tc-99m bicisate. This code is specifically for diagnostic purposes and should not be used for therapeutic or treatment procedures. It is important to review the specific guidelines and requirements of the payer to ensure accurate usage of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9557, healthcare providers need to document the following:

• Date of service
• Per study dose of Technetium tc-99m bicisate administered
• Medical necessity for the diagnostic study
• Any additional relevant information or documentation required by the payer

Proper documentation is essential for accurate billing and reimbursement. It is important to follow the specific guidelines and requirements of the payer to ensure compliance.

6. Historical Information and Code Maintenance

HCPCS code A9557 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 remained unchanged since its inclusion in the coding system.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code A9557 may vary depending on the specific payer. It is important to review the pricing indicator code and multiple pricing indicator code to understand how the service or supply is priced by Medicare or other insurers. The pricing indicator code 57 indicates that the code is priced by other carriers, and the multiple pricing indicator code A indicates that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code A9557 should be billed:

1. A patient undergoes a diagnostic study using Technetium tc-99m bicisate to assess cerebral blood flow.
2. A physician orders a diagnostic study using Technetium tc-99m bicisate to evaluate brain perfusion in a patient with suspected cerebrovascular disease.
3. A radiologist performs a diagnostic study using Technetium tc-99m bicisate to assess brain function in a patient with a history of traumatic brain injury.
4. A nuclear medicine technologist administers Technetium tc-99m bicisate for a diagnostic study to evaluate brain metabolism in a patient with suspected neurodegenerative disease.
5. A neurologist orders a diagnostic study using Technetium tc-99m bicisate to assess brain perfusion in a patient with suspected Alzheimer’s disease.