How To Use HCPCS Code A9575

HCPCS code A9575 describes the injection of gadoterate meglumine in a volume of 0.1 ml. This code is used to identify the administration of this specific contrast agent during diagnostic radiology procedures. In this article, we will explore the details of HCPCS code A9575, 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 A9575?

HCPCS code A9575 is used to identify the injection of gadoterate meglumine, a contrast agent, in a volume of 0.1 ml. This code specifically applies to diagnostic radiology procedures where the use of this contrast agent is necessary. It is important to note that this code is not applicable for other types of injections or procedures.

2. Official Description

The official description of HCPCS code A9575 is “Injection, gadoterate meglumine, 0.1 ml.” This description accurately represents the specific procedure that this code identifies. The short description is “Inj gadoterate meglumi 0.1ml,” which provides a concise summary of the code’s purpose.

3. Procedure

1. The provider prepares the necessary equipment and verifies the patient’s information.
2. The provider ensures that the patient is properly positioned for the diagnostic radiology procedure.
3. The provider administers the gadoterate meglumine injection in a volume of 0.1 ml.
4. The provider monitors the patient for any immediate adverse reactions or complications.
5. The provider proceeds with the diagnostic radiology procedure, utilizing the contrast agent as necessary.

4. When to use HCPCS code A9575

HCPCS code A9575 should be used when a diagnostic radiology procedure requires the administration of gadoterate meglumine in a volume of 0.1 ml. It is important to ensure that the specific contrast agent and volume match the requirements of the procedure being performed. Providers should refer to the relevant guidelines and documentation to determine the appropriate use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9575, healthcare providers need to document the administration of gadoterate meglumine in a volume of 0.1 ml during the diagnostic radiology procedure. This documentation should include the date of service, the patient’s information, the specific procedure performed, and any relevant medical necessity or indications for the use of the contrast agent. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code A9575 was added to the Healthcare Common Procedure Coding System on January 01, 2014. 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, providing consistent identification for the administration of gadoterate meglumine in a volume of 0.1 ml.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the administration of gadoterate meglumine in a volume of 0.1 ml, as identified by HCPCS code A9575. The pricing indicator code 57 indicates that this code is priced by other carriers, and the multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Providers should refer to the specific guidelines and policies of each payer to determine coverage and reimbursement for this procedure.

8. Examples

Here are five examples of when HCPCS code A9575 should be billed:

1. A patient undergoes an MRI scan with contrast, and gadoterate meglumine is administered in a volume of 0.1 ml.
2. A diagnostic radiology procedure requires the use of gadoterate meglumine as a contrast agent, and the injection volume is 0.1 ml.
3. A patient with a suspected vascular abnormality undergoes an angiography procedure, and gadoterate meglumine is administered in a volume of 0.1 ml.
4. A follow-up CT scan is performed, and gadoterate meglumine is used as a contrast agent in a volume of 0.1 ml.
5. A patient with a suspected brain tumor undergoes an MRI scan, and gadoterate meglumine is administered in a volume of 0.1 ml to enhance the visualization of the tumor.