Summary & Overview
HCPCS A9510: Technetium tc-99m Disofenin Diagnostic Dose
HCPCS Level II code A9510 represents a diagnostic radiopharmaceutical dose of Technetium tc-99m disofenin, up to 15 millicuries, used in nuclear medicine imaging. The code identifies a specific tracer dose rather than a procedural service, which affects how imaging facilities and payers classify and reimburse radiopharmaceuticals. Nationally, radiopharmaceutical coding matters for accurate billing, supply management, and compliance with payer coverage rules.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for A9510, how it is reported on claims, and the typical settings where the dose is administered. The publication outlines expected benchmarks and payment considerations, common billing modifiers associated with radiopharmaceuticals, and policy-related factors that influence coverage and claim adjudication.
This analysis explains the clinical use of technetium tc-99m disofenin in diagnostic studies, the relevance of per-dose HCPCS coding for inventory and cost tracking, and the implications for facilities that perform nuclear medicine procedures. Data not available in the input are noted where appropriate.
Billing Code Overview
HCPCS Level II code A9510 describes Technetium tc-99m disofenin, diagnostic, per study dose, up to 15 millicuries. This entry represents a single diagnostic radiopharmaceutical dose used in nuclear medicine imaging procedures that employ technetium-labeled disofenin as the tracer.
Service Type: Diagnostic radiopharmaceutical administration for nuclear medicine imaging
Typical Site of Service: Hospital outpatient departments, hospital-based nuclear medicine suites, and freestanding imaging centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred by a primary care physician or gastroenterologist for a hepatobiliary iminodiacetic acid (HIDA) scan using Technetium Tc-99m disofenin to evaluate biliary tract function and cystic duct patency. Common presenting complaints include right upper quadrant abdominal pain, suspected acute or chronic cholecystitis, postoperative biliary leak, or unexplained jaundice. The patient is scheduled to arrive fasting; a technologist confirms identity, allergies, and pregnancy status. An intravenous line is placed for radiotracer injection. The nuclear medicine physician reviews relevant history and indicates whether morphine augmentation or fatty meal stimulation will be used. The technologist injects up to 15 millicuries of Technetium Tc-99m disofenin (billed as A9510), and dynamic imaging of the liver, biliary tree, gallbladder, and small bowel is performed over approximately 60–90 minutes, with additional delayed images as required. Image interpretation documents tracer uptake, hepatic extraction, visualization of the gallbladder, ejection fraction if cholecystokinin (CCK) is administered, and presence of bile leak or obstruction. Results are reported to the ordering clinician for management decisions such as surgical consultation or further imaging.
Coding Specifications
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