How To Use HCPCS Code A9570

HCPCS code A9570 describes the use of Indium in-111 labeled autologous white blood cells for diagnostic purposes. This code is used to identify the administration of this radiopharmaceutical agent, which is used in nuclear medicine imaging studies. In this article, we will explore the details of HCPCS code A9570, 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 A9570?

HCPCS code A9570 is used to identify the administration of Indium in-111 labeled autologous white blood cells for diagnostic purposes. Autologous white blood cells are cells that are collected from a patient’s own blood and labeled with Indium in-111, a radioactive isotope. These labeled cells are then injected back into the patient’s body for imaging studies.

2. Official Description

The official description of HCPCS code A9570 is “Indium in-111 labeled autologous white blood cells, diagnostic, per study dose.” This description accurately reflects the purpose and usage of this code. The short description of this code is “Indium in-111 auto wbc.”

3. Procedure

1. The procedure for HCPCS code A9570 involves the collection of a patient’s white blood cells through a process called leukapheresis.
2. Once the white blood cells are collected, they are labeled with Indium in-111, a radioactive isotope.
3. The labeled white blood cells are then reinfused back into the patient’s body.
4. After a suitable waiting period, the patient undergoes nuclear medicine imaging studies to visualize the distribution and activity of the labeled white blood cells.
5. The results of these imaging studies help in the diagnosis and evaluation of various conditions, such as infections, inflammation, and certain types of cancers.

4. When to use HCPCS code A9570

HCPCS code A9570 should be used when a healthcare provider administers Indium in-111 labeled autologous white blood cells for diagnostic purposes. This code is typically used in cases where there is a suspicion of infection, inflammation, or certain types of cancers that can be detected through nuclear medicine imaging studies using labeled white blood cells.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9570, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation of the medical necessity for the use of Indium in-111 labeled autologous white blood cells for diagnostic purposes.
• Documentation of the administration of the radiopharmaceutical agent, including the dosage and route of administration.
• Documentation of the nuclear medicine imaging studies performed after the administration of the labeled white blood cells.
• Submission of the appropriate claim form with the correct HCPCS code A9570.

6. Historical Information and Code Maintenance

HCPCS code A9570 was added to the Healthcare Common Procedure Coding System on January 01, 2008. 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 suggests that the code has remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code A9570 is eligible for coverage by Medicare and other insurance providers. 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. The exact reimbursement rates may vary depending on the specific carrier and the terms of the insurance policy.

8. Examples

Here are five examples of scenarios where HCPCS code A9570 should be billed:

1. A patient with suspected osteomyelitis undergoes nuclear medicine imaging using Indium in-111 labeled autologous white blood cells to determine the extent and location of the infection.
2. A patient with a history of recurrent infections undergoes nuclear medicine imaging studies using labeled white blood cells to evaluate the immune system’s response and identify any underlying abnormalities.
3. A patient with suspected inflammatory bowel disease undergoes nuclear medicine imaging using Indium in-111 labeled autologous white blood cells to assess the presence and severity of inflammation in the gastrointestinal tract.
4. A patient with a suspected abscess undergoes nuclear medicine imaging studies using labeled white blood cells to identify the location and extent of the abscess for appropriate treatment planning.
5. A patient with a suspected infection in a joint or prosthesis undergoes nuclear medicine imaging using Indium in-111 labeled autologous white blood cells to determine the presence and location of the infection.