Summary & Overview
HCPCS A9555: Rubidium Rb-82 Diagnostic Dose, Up to 60 mCi
HCPCS Level II code A9555 designates a diagnostic radiopharmaceutical: Rubidium Rb-82, per study dose, up to 60 millicuries. This code is central to PET myocardial perfusion imaging, a nuclear cardiology procedure used to assess myocardial blood flow and perfusion defects. Nationally, the use of rubidium-82 is important for centers offering PET cardiac imaging because it enables rapid, high-quality perfusion studies compared with some conventional SPECT tracers.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what the code represents, typical sites of service, and which payers commonly cover the service. The publication provides benchmarks where available, a summary of clinical context for rubidium-82 PET perfusion studies, and notes on billing practices and documentation expectations tied to radiopharmaceutical administration.
This summary serves clinicians, billing professionals, and policy analysts seeking a national overview of HCPCS Level II code A9555, its clinical role in myocardial perfusion imaging, and the payer landscape relevant to coverage and claims processing. Data not available in the input will be identified as such in detailed sections.
Billing Code Overview
HCPCS Level II code A9555 describes Rubidium Rb-82, diagnostic, per study dose, up to 60 millicuries. This code represents a radiopharmaceutical dose used for diagnostic myocardial perfusion imaging studies that employ rubidium-82 as the tracer.
Service type: Diagnostic radiopharmaceutical administration for nuclear cardiology perfusion imaging.
Typical site of service: Hospital outpatient departments, cardiac imaging centers, and nuclear medicine suites where PET myocardial perfusion studies are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of ischemic heart disease and exertional chest pain is referred for myocardial perfusion imaging using rubidium-82 PET to evaluate for reversible myocardial ischemia. The clinical workflow begins with referral by a cardiologist or primary care physician, review of indications and contraindications, and verification of prior imaging and renal function. On the day of service the patient arrives to an outpatient nuclear medicine or PET/CT suite (typical site of service: hospital outpatient department or independent diagnostic testing facility). Intravenous access is obtained and baseline vital signs are recorded. A rest perfusion PET study may be performed first with administration of A9555 (rubidium rb-82, diagnostic, per study dose, up to 60 millicuries) followed by gated PET acquisition. If stress imaging is indicated, pharmacologic (regadenoson or adenosine) or exercise stress is performed and a second dose of A9555 is administered during peak stress with repeat gated perfusion acquisition. Image reconstruction, attenuation correction (often using low-dose CT), and quantitative perfusion analysis are performed by nuclear medicine physicians or cardiologists trained in cardiac PET. The professional component includes image interpretation and report generation; the technical component includes radiopharmaceutical supply, infusion system, PET scanner time, and technologist services. Relevant documentation includes indication, administered dose in mCi, lot and expiration for the radiopharmaceutical, stress protocol and agent, any adverse events, and the interpreting physician’s structured report with findings and impression.
Coding Specifications
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