A9567 HCPCS - TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, PER STUDY DOSE, UP TO 75 MILLICURIES

Code Information

HCPCS Code: A9567
Sequence Number: 0010
Short Description: Technetium tc-99m aerosol
Long Description: Technetium tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
Date Added: 1/1/2006
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2006
Classification: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
Coding System: HCPCS

Pricing Indicator Code:
- 57 - Other carrier priced
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	A9567
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 pentetate, diagnostic, aerosol, per study dose, up to 75 millicuries
HCPCS Short Description	Technetium tc-99m aerosol
HCPCS Pricing Indicator Code 1	57 - Other carrier priced
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	1/1/2006
HCPCS Action Effective Date	1/1/2006
HCPCS Action Code	N - No maintenance for this code