| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
G0219 |
| 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 |
Pet imaging whole body; melanoma for non-covered indications |
| HCPCS Short Description |
Pet img wholbod melano nonco |
| HCPCS Pricing Indicator Code 1 |
00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) |
| HCPCS Multiple Pricing Indicator Code |
9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') |
| HCPCS Coverage Issues Manual Reference Section Number 1 |
50-36 |
| HCPCS Medicare Carriers Manual Reference Section Number 1 |
4173 |
| HCPCS Coverage Code |
M - Non-covered by Medicare |
| HCPCS Berenson-Eggers Type Of Service Code |
I4B - Imaging/procedure - other |
| HCPCS Type Of Service Code 1 |
4 - Diagnostic radiology |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
7/1/2001 |
| HCPCS Action Effective Date |
7/1/2001 |
| HCPCS Action Code |
N - No maintenance for this code |