Summary & Overview
HCPCS A9548: Indium In-111 Pentetate, Diagnostic, per 0.5 mCi
HCPCS Level II code A9548 designates Indium In-111 pentetate supplied for diagnostic use, measured per 0.5 millicurie. As a radiopharmaceutical supply code, it is central to nuclear medicine imaging workflows used to localize and characterize physiological processes. Nationally, accurate coding for radiopharmaceuticals like A9548 affects billing transparency, claims adjudication, and access to specialty imaging studies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for Indium In-111 pentetate, typical sites of service, and payer coverage considerations. The publication outlines common billing modifiers associated with this supply (input provided), typical service line placement, and what benchmarking or policy updates to monitor for radiopharmaceutical reimbursement and coverage.
The report is organized to deliver practical reference points: a definition and service description, payer coverage overview, allowable billing modifiers, and areas where data was not provided in the input. This summary equips coding managers, revenue cycle staff, and policy analysts with the essential facts needed to align clinical use with billing practice for HCPCS Level II code A9548.
Billing Code Overview
HCPCS Level II code A9548 represents Indium In-111 pentetate, diagnostic, per 0.5 millicurie. This supply is used for nuclear medicine diagnostic imaging involving the radiolabeled chelate indium-111 pentetate, typically for localization and imaging of specific physiological processes. The service type is diagnostic radiopharmaceutical supply. The typical site of service is hospital outpatient radiology/nuclear medicine departments and freestanding imaging centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient referred by a neurologist, oncologist, pulmonologist, or infectious disease specialist for a diagnostic radionuclide study to evaluate cerebrospinal fluid (CSF) leaks, shunt patency, cisternography, or radiographic localization of suspected CSF fistula. The procedure involves intrathecal administration of A9548 (Indium-111 pentetate) by an interventional radiologist, nuclear medicine physician, or neurosurgeon in an outpatient hospital imaging department or free-standing nuclear medicine facility. After intrathecal injection, the patient undergoes serial planar and SPECT imaging over several hours to days to assess tracer distribution.
Typical workflow:
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Referral and preauthorization as required by payer.
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Pre-procedure review of indications, allergies, and prior imaging; consent obtained.
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Intrathecal injection performed under sterile technique by the proceduralist;
A9548dose measured in 0.5 millicurie units per billing increment. -
Immediate and delayed nuclear imaging performed by nuclear medicine technologists under physician supervision; imaging sessions may occur in the same site of service (outpatient hospital or imaging center).
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Image interpretation and written report issued by the interpreting physician; professional and technical components may be reported separately using appropriate modifiers.
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Post-procedure monitoring for headache, infection signs, or allergic reaction; discharge per facility protocols.