How To Use HCPCS Code A9581

HCPCS code A9581 describes the injection of gadoxetate disodium, 1 ml. This code is used to identify the administration of gadoxetate disodium, a contrast agent used in magnetic resonance imaging (MRI) procedures. In this article, we will explore the official description of HCPCS code A9581, the procedure involved, when to use this code, billing guidelines and documentation requirements, historical information and code maintenance, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A9581?

HCPCS code A9581 is used to identify the injection of gadoxetate disodium, 1 ml. Gadoxetate disodium is a contrast agent that is administered intravenously during MRI procedures. It helps enhance the visibility of certain organs and blood vessels, allowing for more accurate diagnosis and evaluation of medical conditions.

2. Official Description

The official description of HCPCS code A9581 is “Injection, gadoxetate disodium, 1 ml.” The short description for this code is “Gadoxetate disodium inj.”

3. Procedure

1. Before administering the injection, the healthcare provider should review the patient’s medical history and ensure that there are no contraindications or allergies to gadoxetate disodium.
2. The provider should prepare the necessary equipment, including a syringe, needle, and the vial containing gadoxetate disodium.
3. The provider should follow proper aseptic technique, ensuring that the injection site is clean and sterile.
4. The provider should withdraw the appropriate amount of gadoxetate disodium from the vial into the syringe.
5. The provider should locate a suitable injection site, typically a vein in the patient’s arm.
6. The provider should insert the needle into the vein and slowly inject the gadoxetate disodium.
7. After the injection, the provider should remove the needle and apply pressure to the injection site to prevent bleeding.
8. The provider should properly dispose of the used syringe and needle in a sharps container.

4. When to use HCPCS code A9581

HCPCS code A9581 should be used when administering gadoxetate disodium during an MRI procedure. This code is specific to the injection of gadoxetate disodium and should not be used for other contrast agents or imaging modalities.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9581, healthcare providers should ensure that the following documentation is included:

• Medical record documentation supporting the medical necessity of the MRI procedure and the use of gadoxetate disodium as a contrast agent.
• Date and time of the injection.
• Quantity of gadoxetate disodium administered (1 ml).
• Provider’s signature and credentials.

6. Historical Information and Code Maintenance

HCPCS code A9581 was added to the Healthcare Common Procedure Coding System on January 01, 2010. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code A9581 may vary depending on the payer. Medicare considers this code as a drug and assigns it a pricing indicator code of 51, indicating that it is priced based on the average sales price. The multiple pricing indicator code for this code is A, indicating that it is not applicable as HCPCS priced under one methodology. Other insurance providers may have their own pricing and coverage policies for this code.

8. Examples

Here are some examples of when HCPCS code A9581 should be billed:

1. A patient undergoes an MRI of the liver with the administration of gadoxetate disodium.
2. A patient undergoes an MRI of the bile ducts with the administration of gadoxetate disodium.
3. A patient undergoes an MRI of the pancreas with the administration of gadoxetate disodium.
4. A patient undergoes an MRI of the kidneys with the administration of gadoxetate disodium.
5. A patient undergoes an MRI of the blood vessels with the administration of gadoxetate disodium.