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    v1.0.28
    OpenPayerBilling CodesAdministrative, Miscellaneous and InvestigationalHCPCS hcpcs-a9515-choline-c11-pet-diagnostic-study-dose
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    HCPCS A9515: Choline C-11 Diagnostic PET Radiotracer

    HCPCS Level II code A9515 describes a diagnostic radiopharmaceutical, choline C-11, billed per study dose up to 20 millicuries for use in nuclear medicine imaging; the service is a diagnostic PET radiotracer administration typically performed in an outpatient nuclear medicine or PET imaging center setting and documented as a single per-study dose for image acquisition and interpretation workflows.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 60-year-old male with biochemical evidence of recurrent prostate cancer (rising PSA) after prior prostatectomy. The clinician orders a diagnostic PET study using A9515 (Choline C-11, per study dose up to 20 millicuries) to localize recurrent or metastatic disease. The clinical workflow: the patient presents to an outpatient nuclear medicine or PET imaging center, screening and consent are obtained, IV access is established, and the radiopharmacy dispenses a patient-specific dose of Choline C-11 within the allowed activity (up to 20 mCi). The patient rests quietly to minimize muscular uptake, then receives tracer injection. After an appropriate uptake period, PET/CT imaging is performed covering the pelvis and abdomen with additional whole-body acquisition as clinically indicated. Images are reconstructed and interpreted by a nuclear medicine physician or radiologist. Final report documents tracer uptake in prostate bed, pelvic lymph nodes, or distant sites to guide further management such as targeted radiation, systemic therapy, or biopsy.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78811Positron emission tomography (PET) diagnostic, limited area, single study, including CT when performed (e.g., for brain, head and neck, chest, abdomen, pelvis); single field of viewUsed when PET/CT acquisition is limited to a region (e.g., pelvis) after administration of A9515.

    | 78812 | Positron emission tomography (PET) diagnostic, limited area, multiple studies, including CT when performed; more than one field of view | Used for multi-region PET acquisitions following Choline C-11 when more than one bed position is needed.

    | 78813 | Positron emission tomography (PET) diagnostic, whole body, single day imaging, including CT when performed | Applied when a whole-body PET/CT is performed after A9515 administration to evaluate metastatic disease.

    | 78814 | Positron emission tomography (PET) diagnostic, multiphase studies, dynamic imaging, including CT when performed | Used when dynamic or multiphase PET acquisition protocols are performed with Choline C-11 for specialized protocols.

    | 77012 | Computed tomography guidance for radiopharmaceutical localization and related diagnostic procedures | May be reported when CT guidance or localization accompanies PET/CT or when additional CT-guided procedures are performed in the same encounter.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    208M00000XHospitalist PhysicianHospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient ca…
    163WX0002XHigh-Risk Obstetric Registered NurseNursing Service Providers · Registered Nurse
    207LP3000XPediatric Anesthesiology PhysicianAn anesthesiologist who has had additional skill and experience in and is primarily concerned with the anesthesia, sedation, and pain management needs…
    273R00000XPsychiatric Hospital UnitIn general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for dia…
    2080C0008XChild Abuse Pediatrics PhysicianA Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agenci…

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-A9150-NON-PRESCRIPTION-DRUGS

    HCPCS Level II A9150: Non-prescription Drugs

    HCPCS-A9152-SINGLE-ORAL-VITAMIN-MINERAL-DOSE

    HCPCS A9152: Single Oral Vitamin/Mineral/Trace Element

    HCPCS-A9153-MULTIVITAMIN-ORAL-PER-DOSE

    HCPCS A9153: Multiple Vitamins, Oral, Per Dose

    HCPCS-A9154-ARTIFICIAL-SALIVA-1ML

    HCPCS Level II A9154: Artificial saliva, 1 ml

    HCPCS-A9155-ARTIFICIAL-SALIVA-30ML

    HCPCS Level II A9155: Artificial Saliva, 30 mL

    HCPCS-A9156-ORAL-MUCOADHESIVE-PER-1ML

    HCPCS Level II A9156: Oral Mucoadhesive, Per 1 ml

    HCPCS-A9180-PEDICULOSIS-TOPICAL-TREATMENT-PATIENT-ADMINISTRATION

    HCPCS Level II A9180: Pediculosis Topical Treatment for Patient/Caretaker

    HCPCS-A9268-PROGRAMMER-TRANSIENT-INGESTED-CAPSULE

    HCPCS Level II A9268: Programmer for Transient Orally Ingested Capsule

    HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

    HCPCS Level II A9269: Programmable Orally Ingested Capsule, Per Month

    HCPCS-A9270-NON-COVERED-ITEM-OR-SERVICE

    HCPCS A9270: Non-covered Item or Service

    Showing 1–10 of 138

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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