Summary & Overview
HCPCS A9536: Technetium tc-99m Depreotide, Diagnostic Dose
HCPCS Level II code A9536 designates a diagnostic radiopharmaceutical dose of technetium tc-99m depreotide (up to 35 millicuries) used in nuclear medicine imaging. The code is relevant for facilities and payers that reimburse radiotracer preparation and supply for diagnostic studies. Nationally, accurate coding for radiopharmaceuticals affects facility billing, inventory management, and alignment with payer coverage policies for advanced imaging agents.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for technetium tc-99m depreotide, typical sites where the service is delivered, and the implications for billing workflows. The publication summarizes common payer interactions and what to expect when submitting claims that include this HCPCS Level II code.
The report provides benchmarks for how the code is used across service lines, notes any relevant policy updates when available, and outlines operational considerations for facilities providing nuclear medicine diagnostic services. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
HCPCS Level II code A9536 describes Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries. This code represents a radiopharmaceutical dose used for nuclear medicine imaging studies that employ technetium-labeled depreotide as the diagnostic agent.
Service Type: Nuclear medicine diagnostic radiopharmaceutical administration
Typical Site of Service: Hospital outpatient radiology/nuclear medicine department or independent imaging center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 60-year-old current or former smoker with a solitary pulmonary nodule identified on chest radiograph or CT and an indeterminate risk of malignancy. The patient is referred to nuclear medicine for a diagnostic radiopharmaceutical study using A9536 (Technetium tc-99m depreotide) to help characterize somatostatin receptor–expressing lesions in the thorax. The clinical workflow: the ordering clinician (pulmonologist or thoracic surgeon) places the order with an indication such as evaluation of an indeterminate pulmonary nodule or suspected lung malignancy. The patient arrives at the imaging center; informed consent and allergy/contrast screening are completed. A licensed nuclear medicine technologist doses and administers up to 35 millicuries of Technetium tc-99m depreotide (A9536) intravenously. Imaging is performed per facility protocol using planar and SPECT or SPECT/CT acquisition after the appropriate uptake period. The interpreting physician (nuclear medicine physician or radiologist) reviews images, generates a report describing focal radiotracer uptake compared with background and correlates with prior CT. The report includes impressions that guide next steps such as biopsy, interval surveillance, or clinical management. Typical sites of service are outpatient hospital-based nuclear medicine departments or freestanding imaging centers. Patient preparation, medication history review, and radiation safety documentation are part of the encounter.
Coding Specifications
| Modifier | Description | When to Use |
|---|