CPI Experts

The bottom line in charge process improvement

(866) 683-4683

  • Home
  • About Us
  • Services
    • Charge Capture Audit
    • Charge Master Review
    • Strategic Pricing Review
  • Industry Info
    • What’s in a Name? The Importance of Being Earnest about CDM Integrity
    • Nuclear Medicine and Charging for Radiopharmaceuticals
    • Infusion & Injection Guidelines
  • Resources
    • Glossary
  • Contact Us

Nuclear Medicine and Charging for Radiopharmaceuticals

Radiopharmaceuticals

The hospital charge master should contain specific charges for all radiopharmaceuticals that are used in conjunction with Nuclear Medicine procedures.

The table below presents the HCPCS Level II for radiopharmaceuticals. The status indicator and the applicable UB-04 revenue codes are also included. The status indicator is part of OPPS and represents whether payment is by APC, by fee schedule, or not paid. The UB-04 revenue code is a four digit number that describes the type of service provided, e.g. 0343 Nuclear Medicine — Diagnostic Radiopharmaceutical, or 0344 Nuclear Medicine — Therapeutic Radiopharmaceutical.

For the table below:

** Status Indicator N means that this is an incidental service and not separately paid under OPPS.

** Status Indicator K means that this is a paid under OPPS

** Status Indicator U means that this is paid under OPPS

HCPCS Code
Description
Status IndicatorRevenue Code
A4641Radiopharmaceutical, diagnostic, not otherwise classifiedN0343
A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuriesN0343
A9500Technetium tc-99m sestamibi, diagnostic, per study doseN0343
A9501Technetium tc-99m teboroxime, diagnostic, per study doseN0343
A9502Technetium tc-99m tetrofosmin, diagnostic, per study doseN0343
A9503Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuriesN0343
A9504Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuriesN0343
A9505Thallium tl-201 thallous chloride, diagnostic, per millicurieN0343
A9507Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuriesN0343
A9508Iodine i-131 iobenguane sulfate, diagnostic, per 0.5 millicurieN0343
A9509Iodine i-123 sodium iodide, diagnostic, per millicurieN0343
A9510Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuriesN0343
A9512Technetium tc-99m pertechnetate, diagnostic, per millicurieN0343
A9515Choline c-11, diagnostic, per study dose up to 20 millicuriesN0343
A9516Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuriesN0343
A9520Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuriesN0343
A9521Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuriesN0343
A9524Iodine i-131 iodinated serum albumin, diagnostic, per 5 microcuriesN0343
A9526Nitrogen n-13 ammonia, diagnostic, per study dose, up to 40 millicuriesN0343
A9528Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurieN0343
A9529Iodine i-131 sodium iodide solution, diagnostic, per millicurieN0343
A9531Iodine i-131 sodium iodide, diagnostic, per microcurie (up to 100 microcuries)N0343
A9532Iodine i-125 serum albumin, diagnostic, per 5 microcuriesN0343
A9536Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuriesN0343
A9537Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuriesN0343
A9538Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuriesN0343
A9539Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuriesN0343
A9540Technetium tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 millicuriesN0343
A9541Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuriesN0343
A9542Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuriesN0343
A9546Cobalt co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 microcurieN0343
A9547Indium in-111 oxyquinoline, diagnostic, per 0.5 millicurieN0343
A9548Indium in-111 pentetate, diagnostic, per 0.5 millicurieN0343
A9550Technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurieN0343
A9551Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuriesN0343
A9552Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuriesN0343
A9553Chromium cr-51 sodium chromate, diagnostic, per study dose, up to 250 microcuriesN0343
A9554Iodine i-125 sodium iothalamate, diagnostic, per study dose, up to 10 microcuriesN0343
A9555Rubidium rb-82, diagnostic, per study dose, up to 60 millicuriesN0343
A9556Gallium ga-67 citrate, diagnostic, per millicurieN0343
A9557Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuriesN0343
A9558Xenon xe-133 gas, diagnostic, per 10 millicuriesN0343
A9559Cobalt co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 microcurieN0343
A9560Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuriesN0343
A9561Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuriesN0343
A9562Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuriesN0343
A9566Technetium tc-99m fanolesomab, diagnostic, per study dose, up to 25 millicuriesN0343
A9567Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuriesN0343
A9568Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuriesN0343
A9569Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study doseN0343
A9570Indium in-111 labeled autologous white blood cells, diagnostic, per study doseN0343
A9571Indium in-111 labeled autologous platelets, diagnostic, per study doseN0343
A9572Indium in-111 pentetreotide, diagnostic, per study dose, up to 6 millicuriesN0343
A9580Sodium fluoride f-18, diagnostic, per study dose, up to 30 millicuriesN0343
A9582Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuriesN0343
A9584Iodine 1-123 ioflupane, diagnostic, per study dose, up to 5 millicuriesN0343
A9586Florbetapir f18, diagnostic, per study dose, up to 10 millicuriesN0343
A9587Gallium ga-68, dotatate, diagnostic, 0.1 millicurieN0343
A9588Fluciclovine f-18, diagnostic, 1 millicurieN0343
A9597Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classifiedN0343
A9598Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classifiedN0343
Q9982Flutemetamol f18, diagnostic, per study dose, up to 5 millicuriesN0343
Q9983Florbetaben f18, diagnostic, per study dose, up to 8.1 millicuriesN0343
C9898Radiolabeled product provided during a hospital inpatient stayN0343 or 0344
A9517Iodine i-131 sodium iodide capsule(s), therapeutic, per millicurieK0344
A9530Iodine i-131 sodium iodide solution, therapeutic, per millicurieK0344
A9543Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuriesK0344
A9563Sodium phosphate p-32, therapeutic, per millicurieK0344
A9600Strontium sr-89 chloride, therapeutic, per millicurieK0344
A9604Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuriesK0344
A9606Radium ra-223 dichloride, therapeutic, per microcurieK0344
A9699Radiopharmaceutical, therapeutic, not otherwise classifiedN0344
A9527Iodine i-125, sodium iodide solution, therapeutic, per millicurieU0344
We at CPI Experts are readily available to assist you with your charge process improvement needs.

Whether you require an assessment of your needs, internal education, or an outsourcing partner for your charge master management, CPI Experts can scale its solutions and expertise to fit your organization.

How can we help?

CPI Experts

102 Tolomato Trace,
Saint Simons Island,
GA 31522

Contact

(866) 683-4683    Phone
(770) 683-1927    Fax

Contact Us
  • About Us
  • Services
  • Industry Info
  • Resources

Copyright © 2023 •  Web Design & Marketing by SEO Advantage, Inc.