How To Use HCPCS Code A9560

HCPCS code A9560 describes the use of Technetium tc-99m labeled red blood cells for diagnostic purposes. This code is used to identify the administration of a study dose of up to 30 millicuries of Tc99m labeled rbc. In this article, we will explore the official description, procedure, when to use the code, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A9560?

HCPCS code A9560 is used to identify the administration of Technetium tc-99m labeled red blood cells for diagnostic purposes. This code specifically refers to the per study dose, which can be up to 30 millicuries. It is important to note that this code is used for diagnostic radiology services.

2. Official Description

The official description of HCPCS code A9560 is “Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries.” The short description for this code is “Tc99m labeled rbc.”

3. Procedure

1. The procedure for HCPCS code A9560 involves the administration of Technetium tc-99m labeled red blood cells to the patient.
2. The study dose can range from a minimum amount up to 30 millicuries.
3. The administration of the labeled red blood cells is done for diagnostic purposes, typically in the field of diagnostic radiology.
4. The provider follows established protocols and guidelines for the safe and accurate administration of the study dose.

4. When to use HCPCS code A9560

HCPCS code A9560 should be used when a healthcare provider administers Technetium tc-99m labeled red blood cells for diagnostic purposes. This code is specifically used for the per study dose, which can be up to 30 millicuries. It is important to ensure that the administration of the labeled red blood cells aligns with the specific guidelines and criteria for using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9560, healthcare providers need to ensure proper documentation of the administration of Technetium tc-99m labeled red blood cells. This includes documenting the study dose administered, the specific diagnostic purpose, and any relevant patient information. It is important to follow the billing guidelines set forth by the relevant payers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A9560 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 been in use since its addition and has not undergone any significant changes or revisions.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code A9560 may vary depending on the payer. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology. It is important to check with Medicare and other insurance providers to determine the specific coverage and reimbursement policies for this code.

8. Examples

Here are five examples of when HCPCS code A9560 should be billed:

1. A patient undergoes a diagnostic radiology study using Technetium tc-99m labeled red blood cells for the evaluation of blood flow in the heart.
2. A physician orders a diagnostic procedure to assess liver function using Technetium tc-99m labeled red blood cells.
3. A patient with suspected gastrointestinal bleeding undergoes a diagnostic study using Technetium tc-99m labeled red blood cells to identify the source of bleeding.
4. A healthcare provider performs a diagnostic radiology study to evaluate blood flow in the brain using Technetium tc-99m labeled red blood cells.
5. A patient with suspected pulmonary embolism undergoes a diagnostic procedure using Technetium tc-99m labeled red blood cells to assess blood flow in the lungs.