Summary & Overview
HCPCS A9552: Fluorodeoxyglucose F-18 (FDG) per Study Dose, up to 45 mCi
HCPCS Level II code A9552 identifies a diagnostic dose of fluorodeoxyglucose F-18 (FDG), billed per study dose up to 45 millicuries, used primarily for positron emission tomography (PET) imaging. This code is important nationally because FDG PET is a widely used molecular imaging tool across oncology, neurology, and cardiology; accurate coding of radiopharmaceutical supply affects clinical documentation, inventory tracking, and payment for imaging episodes.
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 FDG PET dosing and typical sites of service, followed by benchmarks and payer coverage patterns where available. The publication outlines common billing considerations tied to radiopharmaceutical supply codes, potential policy updates affecting reimbursement and billing practices, and the implications for facility claims and service-line revenue.
The content is organized to help revenue cycle and compliance teams, imaging service managers, and policy analysts understand how HCPCS Level II code A9552 is used, which payers commonly process these charges, and what operational and policy factors influence billing and coverage for FDG PET radiopharmaceuticals. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A9552 represents fluorodeoxyglucose F-18 (FDG) for diagnostic use, billed per study dose up to 45 millicuries. This code describes the radiopharmaceutical dose supplied for FDG PET imaging studies.
Service type: Radiopharmaceutical supply for PET diagnostic imaging.
Typical site of service: Hospital outpatient imaging departments, freestanding PET/CT centers, and ambulatory imaging facilities.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of non-small cell lung cancer presents for staging and assessment of suspected metastatic disease. The patient is referred for a diagnostic positron emission tomography (PET) scan using Fluorodeoxyglucose F-18 (FDG) to evaluate metabolic activity of a pulmonary mass and regional lymph nodes. The clinical workflow includes: referral by the oncology or pulmonary physician, review of indications and contraindications, patient fasting for at least 4–6 hours, blood glucose assessment prior to radiotracer injection, intravenous administration of FDG (up to 45 millicuries per study dose billed under A9552), uptake period (approximately 60 minutes), image acquisition on a PET or PET/CT scanner, image reconstruction and interpretation by a credentialed nuclear medicine physician or radiologist, and documentation of dose administered, lot number, and patient response.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation of the imaging study separate from technical services |