How To Use HCPCS Code A9578

HCPCS code A9578 describes the injection of gadobenate dimeglumine, also known as multihance multipack. 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 A9578, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS A9578?

HCPCS code A9578 is used to identify the injection of gadobenate dimeglumine, which is a contrast agent commonly used in diagnostic radiology procedures. This code specifically refers to the multihance multipack, which contains the necessary dosage of the contrast agent for administration. It is important to note that HCPCS codes are used for billing and reporting purposes, and A9578 specifically represents the injection of this particular contrast agent.

2. Official Description

The official description of HCPCS code A9578 is “Injection, gadobenate dimeglumine (multihance multipack), per ml.” This description accurately reflects the nature of the code, indicating that it represents the injection of the multihance multipack, which contains gadobenate dimeglumine, a contrast agent used in diagnostic radiology procedures.

3. Procedure

1. The provider prepares the multihance multipack, ensuring that the dosage is appropriate for the specific diagnostic radiology procedure.
2. The provider verifies the patient’s eligibility for the contrast agent administration and ensures that it is medically necessary for the procedure.
3. The provider administers the injection of gadobenate dimeglumine from the multihance multipack.
4. The provider monitors the patient for any adverse reactions or complications following the injection.
5. The provider documents the administration of the contrast agent, including the dosage, route of administration, and any relevant patient information.

4. When to use HCPCS code A9578

HCPCS code A9578 should be used when the provider administers the multihance multipack, containing gadobenate dimeglumine, during a diagnostic radiology procedure. It is important to ensure that the use of this contrast agent is medically necessary and appropriate for the specific procedure being performed. The code should not be used for any other contrast agents or unrelated services.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9578, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the administration of the multihance multipack, including the dosage and route of administration.
• Documentation of the specific diagnostic radiology procedure for which the contrast agent was administered.
• Documentation of the medical necessity for using the contrast agent.
• Any additional documentation required by the payer or insurance provider.

6. Historical Information and Code Maintenance

HCPCS code A9578 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 other insurance providers may cover the administration of gadobenate dimeglumine (multihance multipack) when it is deemed medically necessary for a diagnostic radiology procedure. The pricing indicator code for A9578 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. The specific coverage and reimbursement details may vary depending on the payer and the individual patient’s insurance plan.

8. Examples

Here are five examples of scenarios in which HCPCS code A9578 should be billed:

1. A patient undergoes an MRI scan with contrast, and the provider administers the multihance multipack during the procedure.
2. A patient undergoes a CT scan with contrast, and the provider administers the multihance multipack during the procedure.
3. A patient undergoes an angiography procedure, and the provider administers the multihance multipack during the procedure.
4. A patient undergoes an arthrogram, and the provider administers the multihance multipack during the procedure.
5. A patient undergoes a myelogram, and the provider administers the multihance multipack during the procedure.