Summary & Overview
HCPCS A9517: Iodine I-131 Sodium Iodide Capsules, Therapeutic
HCPCS Level II code A9517 denotes therapeutic iodine I-131 sodium iodide supplied in capsule form and billed per millicurie. This code is used for radioactive iodine therapies most commonly applied in endocrinology and oncology—such as treatment of hyperthyroidism and certain thyroid cancers—and is a key supply code for providers managing radioisotope dosing and dispensing. Nationally, accurate coding of radiopharmaceuticals like A9517 affects billing clarity, compliance with radiopharmacy regulations, and reimbursement for high-cost, dose-dependent therapies.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise policy and billing context for A9517, including typical sites of service, clinical applications, and the role of per-millicurie billing in dose-based radioactive therapies. The publication summarizes benchmarks where available, discusses payer coverage patterns and claim considerations, and outlines relevant coding relationships for radiopharmaceutical supply. Data limitations where specific payer policies or taxonomy mappings are not provided are noted as unavailable in the input. This piece is intended to inform billing staff, revenue cycle managers, and policy analysts about the operational and coding significance of HCPCS Level II code A9517 in national practice.
Billing Code Overview
HCPCS Level II code A9517 describes iodine I-131 sodium iodide capsules, therapeutic, billed per millicurie. The code represents radioactive iodine therapy supplied in capsule form for therapeutic use, typically measured and billed on a per-millicurie basis.
Service Type: Therapeutic radioactive iodine (I-131) administration supply
Typical Site of Service: Hospital outpatient, nuclear medicine clinic, specialty oncology or endocrinology clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged adult with hyperthyroidism or thyroid cancer who requires therapeutic radioiodine treatment using oral sodium iodide I-131 capsules. The patient is evaluated in an outpatient nuclear medicine clinic or endocrinology infusion center. Pre-procedure workflow includes informed consent, review of recent thyroid function tests, pregnancy test for women of childbearing potential, medication reconciliation (holding interfering medications such as antithyroid drugs when indicated), and measurement of thyroglobulin or TSH levels when used for remnant ablation or metastatic disease. On the day of service, the nuclear medicine technologist and physician verify the prescribed activity in millicuries, confirm radiation safety precautions, administer A9517 by oral capsule with documentation of lot number and activity per millicurie, and provide written discharge instructions including radiation precautions and follow-up imaging or lab orders. Typical sites of service are hospital outpatient departments or freestanding nuclear medicine clinics; inpatient administration may occur for high-dose therapy with appropriate isolation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; not typically applied to outpatient I-131 therapy claims. |