Summary & Overview
HCPCS A9557: Technetium tc-99m bicisate, Diagnostic Brain Imaging
HCPCS Level II code A9557 designates technetium tc-99m bicisate supplied for diagnostic use, per study dose up to 25 millicuries. This radiopharmaceutical is used primarily in nuclear medicine brain imaging to evaluate neurological conditions and is billed separately from imaging procedure codes. Nationally, accurate coding of radiopharmaceuticals like A9557 affects clinical documentation, supply costs, and payment flows across hospital outpatient departments and freestanding imaging centers.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of billing context for A9557, how common sites of service handle radiopharmaceutical dosing and supply, and the types of benchmarks and policy issues that typically affect reimbursement and coverage for diagnostic radiopharmaceuticals.
This publication summarizes payment and coverage considerations, common billing practices, and clinical context for technetium tc-99m bicisate in diagnostic brain studies. It highlights where stakeholders should focus when verifying coverage, documenting clinical indication, and reconciling supply charges with procedure claims. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A9557 describes technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries. This billing code represents a radiopharmaceutical used for diagnostic nuclear medicine brain imaging studies, typically administered as a single-study dose of up to 25 millicuries.
Service Type: Diagnostic radiopharmaceutical administration for nuclear medicine brain imaging
Typical Site of Service: Hospital outpatient imaging departments, freestanding nuclear medicine or radiology centers, and ambulatory surgical centers offering diagnostic nuclear medicine services
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred from neurology or primary care for brain perfusion imaging after new or worsening neurological symptoms such as transient ischemic attacks, unexplained syncope, progressive cognitive decline, or focal neurological deficits. The patient arrives at the nuclear medicine department, is screened for pregnancy and breastfeeding, and IV access is obtained. Radiopharmacy dispenses A9557 (technetium tc-99m bicisate) up to 25 millicuries per study. The tracer is injected intravenously and the patient rests quietly for the required uptake period. Imaging is performed using a gamma camera or SPECT/CT scanner to assess regional cerebral perfusion. The nuclear medicine physician reviews raw and processed images, generates a diagnostic report, and the images and report are routed to the referring provider. Typical sites of service are outpatient imaging centers, hospital outpatient departments, and inpatient radiology/nuclear medicine suites when admitted patients require the study.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier - standard reporting | Use when no special circumstances apply. |
52 |