Summary & Overview
HCPCS A9509: Iodine I-123 Sodium Iodide, Diagnostic, Per Millicurie
HCPCS Level II code A9509 identifies iodine I-123 sodium iodide supplied for diagnostic nuclear medicine studies and is reported per millicurie. This radiopharmaceutical is routinely used in thyroid imaging and functional assessment, making the code relevant for imaging centers, hospital outpatient radiology departments, and other settings that perform diagnostic nuclear medicine. Nationally, consistent coding for radiopharmaceuticals supports accurate claims processing, inventory management, and payment for diagnostic imaging services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the agent, typical sites of service, and payer coverage context. The publication highlights benchmarks and reimbursement context where available, summarizes relevant policy considerations for billing radiopharmaceuticals per millicurie, and provides clinical context about use in thyroid imaging.
The article is organized to give quick access to essentials—what the code represents and where it is used—followed by payer coverage summaries, common modifiers and billing considerations, and links to related guidance. Data not provided in the input (such as specific payer rates, associated taxonomies, or ICD-10 mappings) are noted as unavailable.
Billing Code Overview
HCPCS Level II code A9509 describes iodine I-123 sodium iodide, used for diagnostic nuclear medicine procedures and reported per millicurie. The code applies to the radiopharmaceutical dose of I-123 sodium iodide administered for diagnostic imaging or functional studies of the thyroid.
Service type: Diagnostic radiopharmaceutical administration (nuclear medicine)
Typical site of service: Hospital outpatient radiology/nuclear medicine department, freestanding imaging center, or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old woman referred by her endocrinologist for a diagnostic thyroid scan and uptake measurement using Iodine I-123 sodium iodide billed as A9509 per millicurie. The patient presents to an outpatient nuclear medicine department or hospital-based nuclear medicine suite after thyroid-stimulating hormone (TSH) and thyroid function tests suggest hyperthyroidism or a need to localize functioning thyroid tissue. The workflow: the technologist verifies indications and allergies, documents current medications (notably recent iodinated contrast and thyroid medications), measures and dispenses the I-123 activity in millicuries, administers the oral capsule or liquid, and records the exact activity administered on the medication log. The patient returns 4–24 hours later for planar imaging and uptake quantification; images are acquired by nuclear medicine technologists and interpreted by a nuclear medicine physician or endocrinologist with nuclear medicine training. Results inform diagnoses such as Graves disease, toxic multinodular goiter, or to evaluate a thyroid nodule or ectopic thyroid tissue, and guide management including antithyroid therapy or consideration of radioiodine ablation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |