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    v1.0.28
    OpenPayerBilling CodesAdministrative, Miscellaneous and InvestigationalHCPCS hcpcs-a9557-technetium-bicisate-diagnostic-brain-imaging
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    HCPCS Level II A9557: Technetium tc-99m bicisate, Diagnostic Per Study Dose

    HCPCS Level II code A9557 denotes technetium tc-99m bicisate supplied for diagnostic nuclear medicine studies, billed per study dose up to 25 millicuries; typical service type is a radiopharmaceutical diagnostic agent used during brain perfusion or other nuclear imaging procedures, with the typical site of service being an outpatient imaging center, hospital radiology/nuclear medicine department, or ambulatory surgical center.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78803Therapeutic, prophylactic, or diagnostic radiopharmaceutical localization; sodium pertechnetate, iodide (incl. thyroid uptake) — single studyNot directly the same tracer but represents radiopharmaceutical localization procedures; listed as a related nuclear medicine service type.
    78830Computed tomography, radiopharmaceutical localization; single study, brain, SPECTCommonly billed for the imaging acquisition portion when SPECT brain acquisition is performed with radiopharmaceutical localization and cross-sectional imaging.
    78835Multiple area SPECT imagingUsed when multiple regions or additional SPECT acquisitions are performed during the same session.
    78990Radiopharmaceutical agent, diagnostic, per study dose, other than specified (placeholder for some agents)Sometimes used in facilities where specific HCPCS is not billed separately; A9557 is the HCPCS-level code describing the agent itself.
    99070Supplies and materials (e.g., drugs, devices) used in the procedure, unlisted itemsUsed to report non-billable supplies associated with the procedure when payor policy permits separate supply charges.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    174400000XSpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
    163WM0102XMaternal Newborn Registered NurseNursing Service Providers · Registered Nurse
    207RS0010XSports Medicine (Internal Medicine) PhysicianAn internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but al…
    163WH1000XHospice Registered NurseNursing Service Providers · Registered Nurse
    246X00000XCardiovascular Specialist/TechnologistAn allied health professional who performs diagnostic examinations at the request or direction of a physician in one or more of the following three ar…

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-A9150-NON-PRESCRIPTION-DRUGS

    HCPCS Level II A9150: Non-prescription Drugs

    HCPCS-A9152-SINGLE-ORAL-VITAMIN-MINERAL-DOSE

    HCPCS A9152: Single Oral Vitamin/Mineral/Trace Element

    HCPCS-A9153-MULTIVITAMIN-ORAL-PER-DOSE

    HCPCS A9153: Multiple Vitamins, Oral, Per Dose

    HCPCS-A9154-ARTIFICIAL-SALIVA-1ML

    HCPCS Level II A9154: Artificial saliva, 1 ml

    HCPCS-A9155-ARTIFICIAL-SALIVA-30ML

    HCPCS Level II A9155: Artificial Saliva, 30 mL

    HCPCS-A9156-ORAL-MUCOADHESIVE-PER-1ML

    HCPCS Level II A9156: Oral Mucoadhesive, Per 1 ml

    HCPCS-A9180-PEDICULOSIS-TOPICAL-TREATMENT-PATIENT-ADMINISTRATION

    HCPCS Level II A9180: Pediculosis Topical Treatment for Patient/Caretaker

    HCPCS-A9268-PROGRAMMER-TRANSIENT-INGESTED-CAPSULE

    HCPCS Level II A9268: Programmer for Transient Orally Ingested Capsule

    HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

    HCPCS Level II A9269: Programmable Orally Ingested Capsule, Per Month

    HCPCS-A9270-NON-COVERED-ITEM-OR-SERVICE

    HCPCS A9270: Non-covered Item or Service

    Showing 1–10 of 138

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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