HCPCS A9604 Code. Sm 153 lexidronam


Table of content for "Sm 153 lexidronam" (HCPCS A9604)

General information on the “A9604” code

HCPCS Code: A9604
Long Description: Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
Short Description: Sm 153 lexidronam

Original information is taken from A9604 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: 6 – Therapeutic radiology

Misc information

Anesthesia Base Unit Quantity: 0
Code Added Date: 20100101
Code Effective Date: 20100101
Action Code: N – No maintenance for this code