How To Use HCPCS Code A9567

HCPCS code A9567 describes the use of Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries. This code is used to identify the administration of a diagnostic aerosol containing Technetium tc-99m pentetate for imaging studies. In this article, we will explore the official description of HCPCS code A9567, the procedure involved, when to use this code, billing guidelines and documentation requirements, historical information and code maintenance, Medicare and insurance coverage, as well as provide examples of when this code should be billed.

1. What is HCPCS A9567?

HCPCS code A9567 is used to identify the administration of Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries. This code specifically refers to the use of a diagnostic aerosol containing Technetium tc-99m pentetate for imaging studies. It is important to note that this code is specific to the study dose and the maximum allowable dose is 75 millicuries.

2. Official Description

The official description of HCPCS code A9567 is “Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries”. The short description for this code is “Technetium tc-99m aerosol”. This code is used to identify the administration of a diagnostic aerosol containing Technetium tc-99m pentetate for imaging studies.

3. Procedure

1. The procedure for HCPCS code A9567 involves the administration of a diagnostic aerosol containing Technetium tc-99m pentetate. This aerosol is typically inhaled by the patient, allowing for the imaging of specific areas of interest.
2. Prior to the administration of the aerosol, the healthcare provider will ensure that the patient is properly positioned and prepared for the imaging study.
3. The aerosol is then administered using a nebulizer or other appropriate delivery system.
4. The patient will be instructed to inhale the aerosol as directed by the healthcare provider.
5. After the administration of the aerosol, the imaging study will be performed to visualize the areas of interest.
6. The results of the imaging study will be interpreted by a qualified healthcare professional to aid in diagnosis and treatment planning.

4. When to use HCPCS code A9567

HCPCS code A9567 should be used when a healthcare provider administers a diagnostic aerosol containing Technetium tc-99m pentetate for imaging studies. This code is specific to the study dose and should only be used when the maximum allowable dose of 75 millicuries is not exceeded. It is important to follow the specific guidelines and eligibility criteria for using this code to ensure accurate billing and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9567, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the administration of the diagnostic aerosol containing Technetium tc-99m pentetate
• Documentation of the study dose administered, up to 75 millicuries
• Documentation of the imaging study performed
• Documentation of the interpretation of the imaging study by a qualified healthcare professional

It is important to accurately code and document the use of HCPCS code A9567 to support the medical necessity and appropriateness of the service provided.

6. Historical Information and Code Maintenance

HCPCS code A9567 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 inception.

7. Medicare and Insurance Coverage

HCPCS code A9567 is covered by Medicare and other insurance carriers. 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, which means that it is not applicable as HCPCS priced under one methodology. Medicare and other insurance carriers will determine the reimbursement amount for this service based on their specific pricing methodologies and fee schedules.

8. Examples

Here are five examples of when HCPCS code A9567 should be billed:

1. A patient undergoes a lung ventilation study using a diagnostic aerosol containing Technetium tc-99m pentetate.
2. A patient undergoes a pulmonary perfusion study using a diagnostic aerosol containing Technetium tc-99m pentetate.
3. A patient undergoes a brain ventilation study using a diagnostic aerosol containing Technetium tc-99m pentetate.
4. A patient undergoes a renal perfusion study using a diagnostic aerosol containing Technetium tc-99m pentetate.
5. A patient undergoes a cardiac perfusion study using a diagnostic aerosol containing Technetium tc-99m pentetate.