Table of content for "In111 ibritumomab, dx" (HCPCS A9542)
General information on the “A9542” code
HCPCS Code: A9542
Long Description: Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries
Short Description: In111 ibritumomab, dx
Original information is taken from A9542 page
Pricing indicators
Pricing Indicator Code 1: 51 – Drugs
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): I1E – Standard imaging - nuclear medicine
Type Of Service 1: 4 – Diagnostic radiology
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20060101
Code Effective Date: 20060101
Action Code: N – No maintenance for this code