| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
A9606 |
| 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 |
Radium ra-223 dichloride, therapeutic, per microcurie |
| HCPCS Short Description |
Radium ra223 dichloride ther |
| 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 |
1/1/2015 |
| HCPCS Action Effective Date |
1/1/2018 |
| HCPCS Action Code |
P - Payment change (MOG, pricing indicator codes, anesthesia base units,Ambulatory Surgical Centers) |