How To Use HCPCS Code A9699

HCPCS code A9699 describes a radiopharmaceutical that is used for therapeutic purposes when no other specific code is available. This code is used to identify a radiopharmaceutical agent that is not classified under any other existing HCPCS code. In this article, we will explore the details of HCPCS code A9699, 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 A9699?

HCPCS code A9699 is a specific code used to identify a radiopharmaceutical agent that is used for therapeutic purposes when no other specific code is available. This code is used when the radiopharmaceutical agent being used does not have a designated HCPCS code. It allows healthcare providers to report and bill for the use of this specific radiopharmaceutical agent in their procedures.

2. Official Description

The official description of HCPCS code A9699 is “Radiopharmaceutical, therapeutic, not otherwise classified.” The short description for this code is “Radiopharm rx agent noc.”

3. Procedure

1. Before using HCPCS code A9699, the healthcare provider must determine that no other specific HCPCS code is available for the radiopharmaceutical agent being used.
2. The healthcare provider must administer the radiopharmaceutical agent to the patient according to the appropriate therapeutic protocol.
3. Documentation of the administration of the radiopharmaceutical agent should be completed in the patient’s medical record.

4. When to use HCPCS code A9699

HCPCS code A9699 should be used when the radiopharmaceutical agent being used for therapeutic purposes does not have a designated HCPCS code. It is important to ensure that no other specific code is available before using A9699. This code allows healthcare providers to accurately report and bill for the use of the radiopharmaceutical agent in their procedures.

5. Billing Guidelines and Documentation Requirements

When billing for the use of HCPCS code A9699, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the specific radiopharmaceutical agent used
• Documentation of the therapeutic purpose for which the radiopharmaceutical agent was administered
• Documentation of the dosage and administration details
• Documentation of the patient’s medical record

These documentation requirements are essential for accurate billing and reimbursement for the use of HCPCS code A9699.

6. Historical Information and Code Maintenance

HCPCS code A9699 was added to the Healthcare Common Procedure Coding System on January 01, 2003. 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 an effective date of January 01, 2006.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code A9699 may vary. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. Healthcare providers should consult with Medicare and other insurance providers to determine coverage and reimbursement for the use of HCPCS code A9699.

8. Examples

Here are five examples of when HCPCS code A9699 should be billed:

1. A patient with a rare form of cancer requires a specific radiopharmaceutical agent for targeted therapy. As there is no specific HCPCS code available for this agent, HCPCS code A9699 is used to report and bill for its use.
2. A patient with a thyroid disorder requires a radiopharmaceutical agent for therapeutic treatment. As there is no specific HCPCS code available for this agent, HCPCS code A9699 is used to report and bill for its use.
3. A patient with a neuroendocrine tumor requires a radiopharmaceutical agent for targeted therapy. As there is no specific HCPCS code available for this agent, HCPCS code A9699 is used to report and bill for its use.
4. A patient with a bone metastasis requires a radiopharmaceutical agent for pain management. As there is no specific HCPCS code available for this agent, HCPCS code A9699 is used to report and bill for its use.
5. A patient with a liver tumor requires a radiopharmaceutical agent for targeted therapy. As there is no specific HCPCS code available for this agent, HCPCS code A9699 is used to report and bill for its use.