How To Use HCPCS Code A9571

HCPCS code A9571 describes the use of Indium in-111 labeled autologous platelets for diagnostic purposes. This code is used to identify the administration of this diagnostic study dose to patients. In this article, we will explore the details of HCPCS code A9571, 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 A9571?

HCPCS code A9571 is used to identify the administration of Indium in-111 labeled autologous platelets for diagnostic purposes. This code specifically refers to the study dose of this diagnostic procedure. It is important to note that this code is not applicable for therapeutic use or any other diagnostic procedures involving Indium in-111 labeled autologous platelets.

2. Official Description

The official description of HCPCS code A9571 is “Indium in-111 labeled autologous platelets, diagnostic, per study dose.” This description accurately reflects the purpose and nature of this code. The short description for this code is “Indium in-111 auto platelet.”

3. Procedure

1. The procedure for HCPCS code A9571 involves the administration of Indium in-111 labeled autologous platelets to the patient.
2. Prior to the administration, the platelets are labeled with Indium in-111, a radioactive isotope.
3. The labeled platelets are then injected into the patient’s bloodstream.
4. Following the injection, the patient undergoes imaging or scanning procedures to assess the distribution and function of the platelets.
5. The results of the diagnostic study are used to aid in the diagnosis and management of certain medical conditions.

4. When to use HCPCS code A9571

HCPCS code A9571 should be used when a healthcare provider administers Indium in-111 labeled autologous platelets for diagnostic purposes. This code is specifically for the study dose of this procedure and should not be used for any other purposes or variations of the diagnostic study.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9571, healthcare providers need to ensure that the following documentation requirements are met:

• Medical necessity for the diagnostic study using Indium in-111 labeled autologous platelets.
• Documentation of the administration of the study dose.
• Supporting documentation for the imaging or scanning procedures performed following the administration.

Providers should also follow the appropriate billing guidelines and coding conventions set forth by the relevant payers and coding authorities.

6. Historical Information and Code Maintenance

HCPCS code A9571 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

Medicare and insurance coverage for HCPCS code A9571 may vary depending on the specific payer and policy. It is important for healthcare providers to verify coverage and reimbursement policies with the respective payers. 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.

8. Examples

Here are five examples of scenarios where HCPCS code A9571 should be billed:

1. A patient with suspected platelet dysfunction undergoes a diagnostic study using Indium in-111 labeled autologous platelets to assess platelet distribution and function.
2. A patient with a history of thrombocytopenia receives a study dose of Indium in-111 labeled autologous platelets to evaluate platelet survival and sequestration.
3. A patient with suspected immune-mediated platelet destruction undergoes a diagnostic study using Indium in-111 labeled autologous platelets to assess platelet kinetics.
4. A patient with suspected platelet sequestration in the spleen undergoes a diagnostic study using Indium in-111 labeled autologous platelets to evaluate platelet distribution.
5. A patient with suspected platelet refractoriness undergoes a diagnostic study using Indium in-111 labeled autologous platelets to assess platelet survival and utilization.