How To Use HCPCS Code A9590

HCPCS code A9590 describes the use of iodine i-131 iobenguane, 1 millicurie. This code is used to identify the specific radiopharmaceutical substance and quantity used in diagnostic radiology procedures. In this article, we will explore the details of HCPCS code A9590, 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 A9590?

HCPCS code A9590 is used to identify the specific radiopharmaceutical substance iodine i-131 iobenguane, with a quantity of 1 millicurie. This code is used in diagnostic radiology procedures to indicate the use of this particular substance for imaging purposes. It is important for medical coders to accurately assign this code to ensure proper documentation and billing for the procedure.

2. Official Description

The official description of HCPCS code A9590 is “Iodine i-131, iobenguane, 1 millicurie.” This description clearly specifies the radiopharmaceutical substance and the quantity used in the procedure. The short description for this code is “Iodine i-131 iobenguane 1mci.”

3. Procedure

1. The procedure for HCPCS code A9590 involves the administration of iodine i-131 iobenguane to the patient.
2. The radiopharmaceutical substance is typically administered intravenously.
3. After administration, the substance is allowed to circulate in the patient’s body.
4. During this time, the substance emits radiation that can be detected by imaging equipment.
5. The imaging equipment captures images of the specific area or organ of interest.
6. These images help healthcare providers in diagnosing and evaluating the patient’s condition.

4. When to use HCPCS code A9590

HCPCS code A9590 should be used when iodine i-131 iobenguane, 1 millicurie, is specifically utilized in a diagnostic radiology procedure. It is important to review the documentation and ensure that the procedure meets the criteria for using this code. The use of this code should be supported by medical necessity and appropriate clinical indications.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9590, healthcare providers need to document the administration of iodine i-131 iobenguane, 1 millicurie, in the patient’s medical record. The documentation should include the dosage administered, the route of administration, and the specific procedure for which the substance was used. It is crucial to follow the billing guidelines set forth by the payer to ensure accurate reimbursement for the procedure.

6. Historical Information and Code Maintenance

HCPCS code A9590 was added to the Healthcare Common Procedure Coding System on January 01, 2020. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated on any changes or revisions to the code in the future.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the use of HCPCS code A9590, depending on the specific circumstances and medical necessity. 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. Healthcare providers should verify coverage and reimbursement policies with the respective payers to ensure proper billing and reimbursement for the procedure.

8. Examples

Here are five examples of when HCPCS code A9590 should be billed:

1. A patient undergoes a diagnostic radiology procedure to evaluate the presence of neuroendocrine tumors. Iodine i-131 iobenguane, 1 millicurie, is administered for imaging purposes, and HCPCS code A9590 is assigned for billing.
2. A follow-up imaging study is performed on a patient who previously received treatment for pheochromocytoma. The administration of iodine i-131 iobenguane, 1 millicurie, is necessary to assess the effectiveness of the treatment. HCPCS code A9590 is used for billing.
3. A patient with suspected metastatic neuroblastoma undergoes a diagnostic radiology procedure. Iodine i-131 iobenguane, 1 millicurie, is administered to visualize the extent of the disease. HCPCS code A9590 is assigned for billing.
4. A physician orders a diagnostic radiology procedure to evaluate the functioning of the adrenal glands. Iodine i-131 iobenguane, 1 millicurie, is administered for imaging purposes, and HCPCS code A9590 is used for billing.
5. A patient with suspected carcinoid tumor undergoes a diagnostic radiology procedure. Iodine i-131 iobenguane, 1 millicurie, is administered to visualize the tumor and determine its characteristics. HCPCS code A9590 is assigned for billing.