HCPCS Level II A9524: Iodine I-131 Iodinated Serum Albumin, Diagnostic

HCPCS Level II code A9524 represents iodine I-131 iodinated serum albumin used diagnostically and billed per 5 microcuries. This radiopharmaceutical test is used to assess blood volume and related physiological measures; it remains relevant for diagnostic workflows in nuclear medicine and specialized laboratory settings.

Payors in the national consideration include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, billing characteristics, and payer coverage patterns for radiopharmaceutical diagnostic services. The publication outlines typical sites of service, common billing modifiers encountered in practice, and the role of this code within nuclear medicine testing portfolios.

The analysis provides benchmarks for utilization and reimbursement where available, summarizes relevant policy considerations affecting radiopharmaceuticals, and clarifies coding and service-line placement for claims processing. Data not available in the input is noted where applicable.

Billing Code Overview

HCPCS Level II code A9524 describes iodine I-131 iodinated serum albumin, used for diagnostic purposes and billed per 5 microcuries. The service involves administration and measurement of radiolabeled iodinated serum albumin to evaluate blood volume and related physiological parameters.

Service type: Diagnostic radiopharmaceutical laboratory test
Typical site of service: Hospital outpatient departments, nuclear medicine departments, diagnostic imaging centers, and specialized laboratories

Clinical Context

A typical patient is an adult referred to a nuclear medicine clinic for diagnostic assessment of plasma volume or protein distribution using radiolabeled serum albumin. The clinician orders A9524 (Iodine I-131 iodinated serum albumin, diagnostic, per 5 microcuries) when a measured radiotracer dose of I-131 labeled albumin is required to calculate plasma volume, assess for protein loss, or evaluate intravascular/extravascular distribution in suspected hypoproteinemia or edema of unclear etiology.

The clinical workflow: the patient arrives to an outpatient nuclear medicine or hospital radiology department; informed consent and allergy review are completed; baseline vitals are recorded. A calibrated dose of I-131 iodinated serum albumin is prepared by the radiopharmacy in microcurie increments and recorded. The technologist administers the measured activity intravenously, documents lot numbers and administered activity, and collects timed blood samples and/or serial whole-body counts as specified by the ordering physician. Samples are sent to the laboratory for radioactivity measurement and calculations for plasma volume or protein distribution. Results are interpreted by a nuclear medicine physician and reported to the referring clinician for management decisions.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — default	Use when no special circumstances apply and service is billed normally.

Taxonomy Code	Specialty	Notes
`207L00000X`	Nuclear Medicine Physician	Interprets study, oversees radiopharmacy dosing and reporting.
`207K00000X`	Diagnostic Radiology	May order or interpret related imaging and coordinate with nuclear medicine.
`3336C0002X`	Clinical Laboratory Director	Oversees laboratory measurements of radioactivity in samples.
`363L00000X`	Radiopharmacist	Prepares and dispenses the I-131 iodinated serum albumin dose.
`356Z00000X`	Nuclear Medicine Technologist	Administers radiopharmaceutical and performs sample collection and counts.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`R60.0`	Localized edema	Used when evaluation of protein distribution or plasma volume helps determine cause of focal edema.
`R60.9`	Edema, unspecified	Applied when generalized edema prompts plasma volume and protein distribution assessment.
`E83.1`	Disorders of plasma proteins and protein metabolism, unspecified	Relevant when abnormal plasma protein levels or suspected protein-losing states require quantification.
`N18.9`	Chronic kidney disease, unspecified	CKD can cause fluid imbalance and altered plasma volume; study may assist assessment.
`E86.0`	Dehydration	Used when assessment of intravascular volume is needed to guide fluid management.
`K90.89`	Other intestinal malabsorption	Protein-losing enteropathy may prompt radiolabeled albumin studies to quantify protein loss.
`I50.9`	Heart failure, unspecified	Heart failure with volume overload may require plasma volume assessment to guide therapy.
`R79.89`	Other specified abnormal findings of blood chemistry	May be used when abnormal protein results lead to further plasma distribution testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`78800`	Radiopharmaceutical therapy or imaging, planar, each additional area; not otherwise specified	May be used for planar nuclear medicine imaging studies performed in conjunction with radiopharmaceutical administration when planar counts or imaging are obtained.
`78803`	Radiopharmaceutical localization, quantitative; single study, single area (including blood sampling)	Used for quantitative radiopharmaceutical localization procedures that include blood sampling and calculations related to plasma volume measurements.
`81000`	Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, ketones, etc.; non-automated, without microscopy	May be performed as part of baseline laboratory testing before radiopharmaceutical administration when indicated.
`36415`	Collection of venous blood by venipuncture	Used for timed blood sample collection required to measure radioactivity after administration of `A9524`.
`99070`	Supplies and materials (except spectacles), noncovered items or supplies, used for patient care, listed separately in addition to procedure	May be billed for additional disposable supplies used during radiopharmaceutical administration or sample handling.

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Summary & Overview