Showing codes A9558 (Xenon xe-133 gas, diagnostic, per 10 millicuries) — A9590 (Iodine i-131, iobenguane, 1 millicurie)

A9558 - Xe133 xenon 10mci
Long description: Xenon xe-133 gas, diagnostic, per 10 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).
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A9559 - Co57 cyano
Long description: Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurie
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).
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A9560 - Tc99m labeled rbc
Long description: Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 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).
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A9561 - Tc99m oxidronate
Long description: Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 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).
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A9562 - Tc99m mertiatide
Long description: Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 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).
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A9563 - P32 na phosphate
Long description: Sodium phosphate p-32, therapeutic, per millicurie
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).
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A9564 - P32 chromic phosphate
Long description: Chromic phosphate p-32 suspension, therapeutic, per millicurie
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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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