How To Use HCPCS Code A9573

HCPCS code A9573 describes an injection of gadopiclenol, 1 ml. This code is used to identify the administration of gadopiclenol, a contrast agent used in diagnostic radiology procedures. In this article, we will explore the details of HCPCS code A9573, 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 A9573?

HCPCS code A9573 is used to identify the injection of gadopiclenol, 1 ml. This code specifically refers to the administration of gadopiclenol, a contrast agent used in diagnostic radiology procedures. It is important to note that this code is specific to the 1 ml dosage of gadopiclenol.

2. Official Description

The official description of HCPCS code A9573 is “Injection, gadopiclenol, 1 ml.” This description accurately reflects the purpose of the code, which is to identify the administration of gadopiclenol in a 1 ml dosage.

3. Procedure

1. Prepare the necessary equipment and supplies for the injection.
2. Verify the patient’s identity and confirm the procedure to be performed.
3. Ensure the patient’s safety and comfort throughout the procedure.
4. Administer the gadopiclenol injection using appropriate sterile techniques.
5. Monitor the patient for any adverse reactions or complications.
6. Document the administration of gadopiclenol in the patient’s medical record.

4. When to use HCPCS code A9573

HCPCS code A9573 should be used when administering gadopiclenol in a 1 ml dosage during diagnostic radiology procedures. It is important to ensure that the specific dosage and contrast agent match the details specified in the code description to accurately report the service provided.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9573, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s medical necessity for the gadopiclenol injection.
• Documentation of the dosage administered (1 ml).
• Documentation of the specific diagnostic radiology procedure performed.
• Any additional relevant documentation supporting the medical necessity and appropriateness of the gadopiclenol injection.

6. Historical Information and Code Maintenance

HCPCS code A9573 was added to the Healthcare Common Procedure Coding System on October 01, 2023. As of this date, 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 future changes or revisions to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code A9573 may vary depending on the specific insurance provider. It is important to consult the Medicare and insurance guidelines to determine the coverage and reimbursement policies for this code. The pricing indicator code for A9573 is 51, which indicates that it falls under the category of drugs. 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 when HCPCS code A9573 should be billed:

1. A patient undergoes a computed tomography (CT) scan with contrast, and 1 ml of gadopiclenol is administered.
2. A magnetic resonance imaging (MRI) scan with contrast is performed, and the patient receives an injection of 1 ml of gadopiclenol.
3. A patient undergoes an angiography procedure, and 1 ml of gadopiclenol is administered to enhance the visualization of blood vessels.
4. A diagnostic radiology procedure requires the use of gadopiclenol as a contrast agent, and the patient receives a 1 ml injection.
5. A patient undergoes a nuclear medicine scan, and 1 ml of gadopiclenol is administered to improve image quality.