| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
A9568 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries |
| HCPCS Short Description |
Technetium tc99m arcitumomab |
| HCPCS Pricing Indicator Code 1 |
53 - Statute |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
I1E - Standard imaging - nuclear medicine |
| HCPCS Type Of Service Code 1 |
4 - Diagnostic radiology |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2007 |
| HCPCS Action Effective Date |
1/1/2007 |
| HCPCS Action Code |
N - No maintenance for this code |