Summary & Overview
HCPCS A9550: Technetium tc-99m Sodium Gluceptate, Diagnostic Dose
HCPCS Level II code A9550 designates technetium tc-99m sodium gluceptate, a radiopharmaceutical supplied for diagnostic nuclear medicine studies (per study dose, up to 25 millicurie). This code is used when a facility or provider bills separately for the diagnostic radiopharmaceutical administered to support imaging procedures. Nationally, radiopharmaceutical coding affects site-of-service billing, inventory management, and payer coverage determinations for nuclear medicine studies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for A9550, typical settings of service, and the role of the radiopharmaceutical in diagnostic workflows. The publication also summarizes benchmarking and policy-relevant considerations affecting reimbursement and claims processing for radiopharmaceuticals.
The report provides practical billing context: how A9550 fits into service lines for outpatient imaging and hospital nuclear medicine, common modifiers associated with radiopharmaceutical billing when present, and what to expect from major payers and Medicare in national coverage patterns. Data not available in the input will be identified where applicable.
Billing Code Overview
HCPCS Level II code A9550 represents technetium tc-99m sodium gluceptate, a radiopharmaceutical used for diagnostic imaging, billed per study dose of up to 25 millicurie. The service type is diagnostic nuclear medicine radiopharmaceutical administration. The typical site of service is outpatient imaging centers, hospital nuclear medicine departments, and ambulatory diagnostic facilities where nuclear medicine studies are performed.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to nuclear medicine for a diagnostic radionuclide bone or infection localization study using technetium tc-99m sodium gluceptate. The patient presents with focal bone pain, suspected occult fracture, osteomyelitis, or prosthetic joint infection after initial radiographs or clinical exam are inconclusive. The scheduling team verifies patient identity, allergies, medications (especially recent radiopharmaceutical injections or iodinated contrast), and pregnancy status for females of childbearing potential. On arrival, an intravenous access is obtained and the radiopharmacist or nuclear medicine technologist prepares a single study dose of A9550 (technetium tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 millicurie). The dose is administered intravenously, and imaging is performed per protocol (planar and/or SPECT or SPECT/CT) at institution-specific time points. Images are acquired and processed by a nuclear medicine technologist and interpreted by a nuclear medicine physician or radiologist. Final imaging report documents indication, radiopharmaceutical and administered activity, imaging technique, findings, and impression. Billing for the radiopharmaceutical uses HCPCS A9550 and is submitted alongside procedure and imaging CPT codes representing image acquisition and interpretation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |