How To Use HCPCS Code A9697

HCPCS code A9697 describes the injection of carboxydextran-coated superparamagnetic iron oxide, per study dose. This code is used in the context of diagnostic radiology procedures and is typically billed by healthcare providers for the administration of this specific medication.

1. What is HCPCS A9697?

HCPCS code A9697 is a specific code used to identify the injection of carboxydextran-coated superparamagnetic iron oxide, per study dose. It is important to note that this code is only applicable for the administration of this particular medication and should not be used for any other purposes.

2. Official Description

The official description of HCPCS code A9697 is “Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose.” The short description for this code is “Inj, magtrace per study dose.”

3. Procedure

1. The provider prepares the carboxydextran-coated superparamagnetic iron oxide medication according to the study dose requirements.
2. The provider ensures that the medication is properly labeled and stored.
3. The provider administers the injection to the patient following the appropriate injection technique.
4. After the injection, the provider monitors the patient for any adverse reactions or side effects.

4. When to use HCPCS code A9697

HCPCS code A9697 should be used when healthcare providers are administering the carboxydextran-coated superparamagnetic iron oxide medication as part of a study dose. It is important to ensure that the medication is being used in accordance with the specific study requirements and guidelines.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9697, healthcare providers need to ensure that they have the necessary documentation to support the administration of the medication. This may include the study protocol, documentation of the patient’s eligibility for the study, and any other relevant documentation. Providers should also follow the appropriate billing guidelines and submit the claim with the correct coding and modifiers, if applicable.

6. Historical Information and Code Maintenance

HCPCS code A9697 was added to the Healthcare Common Procedure Coding System on October 01, 2023. 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.

7. Medicare and Insurance Coverage

The coverage of HCPCS code A9697 may vary depending on the specific insurance provider and policy. It is important for healthcare providers to verify the coverage and reimbursement policies of Medicare and other insurance companies before administering the medication and submitting the claim. 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.

8. Examples

Here are five examples of scenarios where HCPCS code A9697 may be billed:

1. A patient is participating in a clinical trial that requires the administration of carboxydextran-coated superparamagnetic iron oxide. The healthcare provider administers the medication as part of the study dose and bills using HCPCS code A9697.
2. A radiology department is conducting a research study that involves the use of carboxydextran-coated superparamagnetic iron oxide. The study protocol requires the administration of the medication, and the department bills for the service using HCPCS code A9697.
3. A patient is undergoing a diagnostic radiology procedure that includes the use of carboxydextran-coated superparamagnetic iron oxide. The healthcare provider administers the medication as part of the procedure and bills using HCPCS code A9697.
4. A research facility is conducting a study to evaluate the effectiveness of carboxydextran-coated superparamagnetic iron oxide in a specific patient population. The facility administers the medication to the study participants and bills using HCPCS code A9697.
5. A healthcare provider is participating in a clinical trial that involves the use of carboxydextran-coated superparamagnetic iron oxide. The provider administers the medication to the trial participants and bills using HCPCS code A9697.