How To Use HCPCS Code A9579

HCPCS code A9579 describes the injection of a gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per milliliter. This code is used to identify the administration of a contrast agent during magnetic resonance imaging (MRI) procedures. In this article, we will explore the details of HCPCS code A9579, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS A9579?

HCPCS code A9579 is specifically used to identify the injection of a gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per milliliter. This code is assigned to the administration of contrast agents during MRI procedures. It is important to note that this code is not specific to any particular gadolinium-based contrast agent, but rather encompasses all such agents that are used in MRI imaging.

2. Official Description

The official description of HCPCS code A9579 is “Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per milliliter.” The short description for this code is “Gad-base MR contrast NOS, 1ml.” This description accurately reflects the purpose of this code, which is to identify the administration of a gadolinium-based contrast agent during MRI procedures.

3. Procedure

1. The provider prepares the gadolinium-based contrast agent according to the manufacturer’s instructions.
2. The provider verifies the patient’s medical history and ensures that there are no contraindications or allergies to gadolinium-based contrast agents.
3. The provider administers the contrast agent via intravenous injection, ensuring proper dosage and aseptic technique.
4. The provider monitors the patient for any adverse reactions or side effects during and after the injection.
5. The provider documents the administration of the contrast agent in the patient’s medical record.

4. When to use HCPCS code A9579

HCPCS code A9579 should be used when a gadolinium-based contrast agent is administered during an MRI procedure. This code is applicable for both diagnostic and therapeutic MRI scans that require the use of a contrast agent. It is important to ensure that the documentation clearly indicates the administration of the contrast agent and the specific dosage used.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9579, healthcare providers need to document the following information:

• Date of service
• Quantity of contrast agent administered in milliliters
• Manufacturer and specific name of the gadolinium-based contrast agent used
• Medical necessity for the use of the contrast agent
• Any relevant patient history or contraindications

It is crucial to ensure accurate and detailed documentation to support the medical necessity and appropriateness of the contrast agent administration.

6. Historical Information and Code Maintenance

HCPCS code A9579 was added to the Healthcare Common Procedure Coding System on January 1, 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 code has been consistently used to identify the administration of gadolinium-based contrast agents during MRI procedures.

7. Medicare and Insurance Coverage

HCPCS code A9579 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 51 indicates that this code falls under the category of drugs. The multiple pricing indicator code A signifies that the pricing for this code is not applicable under multiple methodologies. Providers should follow the specific guidelines and reimbursement policies of each insurance carrier to ensure proper billing and reimbursement for the administration of gadolinium-based contrast agents.

8. Examples

Here are five examples of scenarios where HCPCS code A9579 should be billed:

1. A patient undergoes an MRI of the brain with the administration of a gadolinium-based contrast agent to evaluate for suspected brain tumor.
2. A patient with a history of renal impairment undergoes an MRI of the abdomen with the administration of a gadolinium-based contrast agent to assess for liver lesions.
3. A patient with a known spinal cord injury undergoes an MRI of the spine with the administration of a gadolinium-based contrast agent to evaluate for spinal cord compression.
4. A patient with a suspected cardiac abnormality undergoes an MRI of the heart with the administration of a gadolinium-based contrast agent to assess myocardial perfusion.
5. A patient with a history of multiple sclerosis undergoes an MRI of the brain and spinal cord with the administration of a gadolinium-based contrast agent to monitor disease progression.