Table of content for "Xe129 xenon, diagnostic" (HCPCS C9150)
General information on the “C9150” code
HCPCS Code: C9150
Long Description: Xenon xe-129 hyperpolarized gas, diagnostic, per study dose
Short Description: Xe129 xenon, diagnostic
Original information is taken from C9150 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Statute Number: 1833(t)
Cross Reference Code 1: A9610 ;
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: 1 – Medical care
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20230701
Code Effective Date: 20241001
Termination Date: 20240930
Action Code: N – No maintenance for this code