Summary & Overview
HCPCS A9505: Thallium Tl-201 Thallous Chloride, Diagnostic, per mCi
HCPCS Level II code A9505 denotes thallium Tl-201 thallous chloride billed per millicurie for diagnostic nuclear medicine procedures. As a radiopharmaceutical code, it is used when thallium-201 is administered to patients for myocardial perfusion imaging and other diagnostic scans that rely on this tracer. Nationally, accurate coding of radiopharmaceuticals supports appropriate reimbursement, inventory tracking, and clinical documentation for imaging services.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical context, typical sites of service, and the common modifiers used with radiopharmaceutical billing. The publication outlines benchmarks for billing practice, coding conventions, and policy considerations relevant to payers listed above.
This summary provides clinicians, billing professionals, and policy analysts with a clear reference for when A9505 applies, what services it represents, and the payer landscape to consult for coverage and reimbursement guidance. Data not available in the input is noted where specific payer policies or utilization metrics would otherwise be expected.
Billing Code Overview
HCPCS Level II code A9505 describes Thallium Tl-201 thallous chloride, diagnostic, per millicurie. This entry represents a radiopharmaceutical agent used for diagnostic nuclear medicine imaging, typically in myocardial perfusion studies and other diagnostic scans that require thallium-201 as the radiotracer.
Service type: Radiopharmaceutical diagnostic agent
Typical site of service: Hospital outpatient radiology/nuclear medicine department or freestanding nuclear medicine imaging center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old male with known or suspected coronary artery disease who is referred for myocardial perfusion imaging using thallium-201 thallous chloride to assess myocardial viability and reversible ischemia. The clinical workflow begins with an outpatient or hospital referral from a cardiologist after symptoms of angina, abnormal stress electrocardiogram, or inconclusive prior imaging. On the day of service the patient arrives at a nuclear medicine or cardiology imaging department. A technologist verifies the indication, obtains informed consent, and confirms no contraindications (for example, pregnancy). The patient receives intravenous administration of A9505 (thallium-201 thallous chloride), dosed per facility protocol (millicurie units). Image acquisition occurs with planar and/or SPECT cameras at specified time points — immediately post-injection for stress imaging and delayed imaging for redistribution or viability assessment. A nuclear medicine physician or cardiologist interprets the images and documents findings comparing stress and delayed images to determine ischemia, infarct size, or viable myocardium. Results are communicated to the referring cardiologist for correlation with clinical management such as revascularization planning or medical therapy optimization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no special modifier applies to the service |