How To Use HCPCS Code A9559

HCPCS code A9559 describes the oral diagnostic use of cobalt co-57 cyanocobalamin, administered as a study dose of up to 1 microcurie. This code is used to identify the specific procedure and is essential for accurate medical coding and billing. In this article, we will explore the details of HCPCS code A9559, 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 A9559?

HCPCS code A9559 is used to identify the oral diagnostic use of cobalt co-57 cyanocobalamin. This code represents a specific procedure that involves the administration of a study dose of up to 1 microcurie. It is important for medical coders to accurately assign this code to ensure proper documentation and billing.

2. Official Description

The official description of HCPCS code A9559 is “Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie.” The short description for this code is “Co57 cyano.”

3. Procedure

1. The provider prepares the cobalt co-57 cyanocobalamin for oral administration.
2. The patient is instructed on the procedure and any necessary precautions.
3. The provider administers the cobalt co-57 cyanocobalamin orally to the patient.
4. The patient may be required to wait for a specific period of time to allow the substance to take effect.
5. The provider performs the necessary diagnostic study or test.

4. When to use HCPCS code A9559

HCPCS code A9559 should be used when the provider performs an oral diagnostic study using cobalt co-57 cyanocobalamin. This code is specific to the administration of the study dose and is not applicable for other uses or procedures. It is important to review the documentation and ensure that the criteria for using this code are met before assigning it.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9559, healthcare providers need to document the administration of cobalt co-57 cyanocobalamin, including the dosage and any relevant details of the diagnostic study. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A9559 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. It is important to stay updated with any changes or revisions to the code in the future.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code A9559 may vary depending on the payer. Medicare and other insurance providers may have specific guidelines and pricing indicators for this code. It is important to review the pricing indicator code and multiple pricing indicator code to understand how the service or supply is priced by the payer.

8. Examples

Here are five examples of scenarios where HCPCS code A9559 should be billed:

1. A patient undergoes an oral diagnostic study using cobalt co-57 cyanocobalamin to assess their gastrointestinal absorption.
2. A provider administers a study dose of cobalt co-57 cyanocobalamin orally to a patient for a diagnostic study of their vitamin B12 levels.
3. A patient with suspected pernicious anemia receives an oral diagnostic study using cobalt co-57 cyanocobalamin to confirm the diagnosis.
4. A provider performs an oral diagnostic study using cobalt co-57 cyanocobalamin to assess a patient’s gastric emptying time.
5. A patient undergoes an oral diagnostic study using cobalt co-57 cyanocobalamin to evaluate their vitamin B12 absorption after gastric bypass surgery.