Table of content for "Indium in-111 pentetreotide" (HCPCS A9572)
General information on the “A9572” code
HCPCS Code: A9572
Long Description: Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuries
Short Description: Indium in-111 pentetreotide
Original information is taken from A9572 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
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: 20080101
Code Effective Date: 20080101
Action Code: N – No maintenance for this code