Summary & Overview
HCPCS A9560: Technetium Tc-99m Labeled Red Blood Cells, Diagnostic
HCPCS Level II code A9560 denotes a diagnostic nuclear medicine procedure using technetium Tc-99m–labeled red blood cells, per study dose up to 30 millicuries. This code captures studies used to localize bleeding, evaluate cardiac blood pool function, and support other diagnostic nuclear medicine indications. Nationally, imaging utilization and correct coding for radiopharmaceutical studies affect hospital radiology workflows, billing accuracy, and compliance with payer policies.
Key payers 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 A9560, typical sites of service, and the administrative considerations that can influence coverage and claims processing. The publication provides benchmark context where available, summarizes relevant policy patterns among major payers, and outlines documentation elements commonly referenced for diagnostic radiopharmaceutical studies.
This summary is intended for coding, billing, and clinical revenue management professionals seeking a focused reference on HCPCS Level II code A9560, its clinical use, and key payer considerations at a national level. Data not available in the input is noted where applicable in the full publication.
Billing Code Overview
HCPCS Level II code A9560 describes Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries. This code is used for nuclear medicine diagnostic studies in which a patient's red blood cells are labeled with technetium Tc-99m to evaluate blood pool activity, identify sites of hemorrhage, or assess cardiac or vascular function as indicated by the clinical study.
-
Service type: Diagnostic nuclear medicine procedure involving radiolabeled red blood cells
-
Typical site of service: Hospital outpatient departments, hospital inpatient nuclear medicine units, and specialized imaging centers
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to nuclear medicine for evaluation of suspected gastrointestinal bleeding or occult blood loss when endoscopy is non-diagnostic or intermittent bleeding is suspected. The referring clinician documents signs such as melena, hematochezia, positive fecal occult blood testing or dropping hemoglobin/hematocrit without clear source. The nuclear medicine team performs a technetium Tc-99m labeled red blood cell (RBC) blood-pool study using A9560 to prepare and dose autologous RBCs (up to 30 millicuries per study dose). The workflow includes: pre-procedure verification of indication and informed consent, phlebotomy to obtain and label the patient’s blood sample, in vitro or in vivo labeling of RBCs with Tc-99m per local protocol, intravenous reinjection of labeled RBCs, dynamic and delayed planar and/or SPECT imaging to localize active bleeding, and post-procedure monitoring. Image interpretation is performed by a radiologist or nuclear medicine physician and reported to the referring clinician for next-step management. Typical sites of service are outpatient hospital-based nuclear medicine departments, hospital inpatient radiology/nuclear medicine suites, and freestanding imaging centers equipped for radiopharmaceutical handling and blood handling under appropriate regulatory controls.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation/report separate from the technical radiopharmacy and imaging services. |