Table of content for "Lutetium lu 177 dotatat ther" (HCPCS A9513)
General information on the “A9513” code
HCPCS Code: A9513
Long Description: Lutetium lu 177, dotatate, therapeutic, 1 millicurie
Short Description: Lutetium lu 177 dotatat ther
Original information is taken from A9513 page
Pricing indicators
Pricing Indicator Code 1: 57 – Other carrier priced
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage Issues Manual Reference Section Number 1: 153.60
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): I1E – Standard imaging - nuclear medicine
Type Of Service 1: 6 – Therapeutic radiology
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20190101
Code Effective Date: 20240101
Action Code: N – No maintenance for this code