Showing codes A9566 (Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries) — A9597 (Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified)

A9566 - Tc99m fanolesomab
Long description: Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuries
Code added date: 20060101.
Code effective date: 20060101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9567 - Technetium tc-99m aerosol
Long description: Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
Code added date: 20060101.
Code effective date: 20060101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9568 - Technetium tc99m arcitumomab
Long description: Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
Code added date: 20070101.
Code effective date: 20070101.
Pricing Indicator Code(s): 53 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9569 - Technetium tc-99m auto wbc
Long description: Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9570 - Indium in-111 auto wbc
Long description: Indium in-111 labeled autologous white blood cells, diagnostic, per study dose
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9571 - Indium in-111 auto platelet
Long description: Indium in-111 labeled autologous platelets, diagnostic, per study dose
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9572 - Indium in-111 pentetreotide
Long description: Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9573 - Inj, gadopiclenol, 1 ml
Long description: Injection, gadopiclenol, 1 ml
Code added date: 20231001.
Code effective date: 20231001.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9575 - Inj gadoterate meglumi 0.1ml
Long description: Injection, gadoterate meglumine, 0.1 ml
Code added date: 20140101.
Code effective date: 20140101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9576 - Inj prohance multipack
Long description: Injection, gadoteridol, (prohance multipack), per ml
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9577 - Inj multihance
Long description: Injection, gadobenate dimeglumine (multihance), per ml
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9578 - Inj multihance multipack
Long description: Injection, gadobenate dimeglumine (multihance multipack), per ml
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9579 - Gad-base mr contrast nos,1ml
Long description: Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml
Code added date: 20080101.
Code effective date: 20080101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9580 - Sodium fluoride f-18
Long description: Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuries
Code added date: 20090101.
Code effective date: 20090101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9581 - Gadoxetate disodium inj
Long description: Injection, gadoxetate disodium, 1 ml
Code added date: 20100101.
Code effective date: 20100101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9582 - Iodine i-123 iobenguane
Long description: Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries
Code added date: 20100101.
Code effective date: 20100101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9583 - Gadofosveset trisodium inj
Long description: Injection, gadofosveset trisodium, 1 ml
Code added date: 20100101.
Code effective date: 20100101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9584 - Iodine i-123 ioflupane
Long description: Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuries
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9585 - Gadobutrol injection
Long description: Injection, gadobutrol, 0.1 ml
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9586 - Florbetapir f18
Long description: Florbetapir f18, diagnostic, per study dose, up to 10 millicuries
Code added date: 20130101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

A9587 - Gallium ga-68
Long description: Gallium ga-68, dotatate, diagnostic, 0.1 millicurie
Code added date: 20170101.
Code effective date: 20240101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9588 - Fluciclovine f-18
Long description: Fluciclovine f-18, diagnostic, 1 millicurie
Code added date: 20170101.
Code effective date: 20240101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9589 - Insti hexaminolevulinate hcl
Long description: Instillation, hexaminolevulinate hydrochloride, 100 mg
Code added date: 20190101.
Code effective date: 20190101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9590 - Iodine i-131 iobenguane 1mci
Long description: Iodine i-131, iobenguane, 1 millicurie
Code added date: 20200101.
Code effective date: 20200101.
Pricing Indicator Code(s): 51 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9591 - Fluoroestradiol f 18
Long description: Fluoroestradiol f 18, diagnostic, 1 millicurie
Code added date: 20210101.
Code effective date: 20240101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9592 - Copper cu 64 dotatate diag
Long description: Copper cu-64, dotatate, diagnostic, 1 millicurie
Code added date: 20210401.
Code effective date: 20240101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9593 - Gallium ga-68 psma-11 ucsf
Long description: Gallium ga-68 psma-11, diagnostic, (ucsf), 1 millicurie
Code added date: 20210701.
Code effective date: 20240701.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9594 - Gallium ga-68 psma-11, ucla
Long description: Gallium ga-68 psma-11, diagnostic, (ucla), 1 millicurie
Code added date: 20210701.
Code effective date: 20240701.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9595 - Piflu f-18, dia 1 millicurie
Long description: Piflufolastat f-18, diagnostic, 1 millicurie
Code added date: 20220101.
Code effective date: 20220101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9596 - Gallium illuccix 1 millicure
Long description: Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie
Code added date: 20220701.
Code effective date: 20220701.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

A9597 - Pet, dx, for tumor id, noc
Long description: Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
Code added date: 20170101.
Code effective date: 20170101.
Pricing Indicator Code(s): 57 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF