How To Use HCPCS Code A9582

HCPCS code A9582 describes the use of iodine i-123 iobenguane for diagnostic purposes. This code is used to identify the administration of this radiopharmaceutical for a specific study dose, up to 15 millicuries. In this article, we will explore the details of HCPCS code A9582, 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 A9582?

HCPCS code A9582 is used to identify the administration of iodine i-123 iobenguane for diagnostic purposes. It specifically refers to the per study dose, up to 15 millicuries. This code is used to accurately report and bill for the use of this radiopharmaceutical in medical imaging studies.

2. Official Description

The official description of HCPCS code A9582 is “Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries.” This description clearly indicates that this code is used for diagnostic purposes and specifies the maximum dose of 15 millicuries.

3. Procedure

1. The procedure for HCPCS code A9582 involves the administration of iodine i-123 iobenguane to the patient.
2. The radiopharmaceutical is typically administered intravenously.
3. The dosage administered should not exceed 15 millicuries for a single study.
4. Proper safety measures should be followed during the administration to minimize radiation exposure.
5. After the administration, the patient undergoes the necessary imaging studies to obtain diagnostic information.

4. When to use HCPCS code A9582

HCPCS code A9582 should be used when iodine i-123 iobenguane is administered for diagnostic purposes. It is important to ensure that the dosage administered does not exceed 15 millicuries for a single study. This code should be used in situations where the use of this radiopharmaceutical is necessary to obtain diagnostic information.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9582, healthcare providers need to ensure proper documentation of the administration of iodine i-123 iobenguane for diagnostic purposes. This includes documenting the dosage administered, the study for which it was used, and any relevant clinical information supporting the need for this radiopharmaceutical. The billing should be done in accordance with the guidelines provided by the payer or insurance company.

6. Historical Information and Code Maintenance

HCPCS code A9582 was added to the Healthcare Common Procedure Coding System on January 01, 2010. 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 inclusion in the coding system.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code A9582 may vary. It is important to check with the specific payer or insurance company to determine if this code is payable. The pricing indicator code for this code is 51, which indicates that it falls under the category of drugs. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. The pricing and coverage details may differ based on the specific policies and guidelines of the payer or insurance company.

8. Examples

Here are five examples of when HCPCS code A9582 should be billed:

1. A patient undergoes a diagnostic imaging study using iodine i-123 iobenguane to assess the presence and extent of neuroendocrine tumors.
2. A physician orders a diagnostic scan with iodine i-123 iobenguane to evaluate the functioning of the adrenal glands in a patient with suspected pheochromocytoma.
3. A nuclear medicine specialist administers iodine i-123 iobenguane for a diagnostic study to determine the presence of metastatic neuroblastoma in a pediatric patient.
4. A patient with suspected paraganglioma undergoes a diagnostic imaging study using iodine i-123 iobenguane to aid in the diagnosis and localization of the tumor.
5. A healthcare provider utilizes iodine i-123 iobenguane for a diagnostic scan to assess the response to treatment in a patient with known or suspected neuroblastoma.