Summary & Overview
HCPCS A9562: Technetium tc-99m Mertiatide, Diagnostic, Up to 15 mCi
HCPCS Level II code A9562 denotes technetium tc-99m mertiatide, a diagnostic radiopharmaceutical supplied per study dose up to 15 millicuries. This agent is routinely used in nuclear medicine for renal imaging, including assessment of renal perfusion and functional studies. The code is relevant across hospital outpatient departments, independent imaging centers, and nuclear medicine suites.
Key payers in national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national-level overview of clinical use, typical sites of service, payer coverage landscape, and common billing considerations tied to radiopharmaceutical services. The publication outlines standard benchmarks for utilization and reimbursement where available, summarizes relevant policy updates affecting radiopharmaceutical coding and billing, and provides clinical context to help coding, billing, and revenue cycle teams align claims processing with the clinical service provided.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line are noted where applicable.
Billing Code Overview
HCPCS Level II code A9562 describes technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries. This code represents a radiopharmaceutical agent used in nuclear medicine imaging studies that evaluate renal function and renal perfusion.
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Service type: Diagnostic radiopharmaceutical administration for renal imaging
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Typical site of service: Hospital outpatient departments, independent diagnostic testing facilities (imaging centers), and nuclear medicine departments
Clinical & Coding Specifications
Clinical Context
A 62-year-old outpatient with known chronic kidney disease and recurrent flank pain is referred for a radionuclide renal scintigraphy using Technetium tc-99m mertiatide to evaluate differential renal function and suspected obstructive uropathy. The patient arrives at the nuclear medicine department fasting as instructed. A technologist reviews allergy history and current medications, establishes IV access, and documents recent creatinine to ensure safety. The radiopharmacy prepares a single diagnostic study dose of A9562 (up to 15 millicuries) and performs quality control. The nuclear medicine physician reviews indications and performs the injection, then supervises dynamic imaging acquisition (angiographic and functional phases) using a gamma camera. Serial images are collected over 20–30 minutes and late static images may be obtained. The interpreting physician provides a structured report documenting tracer uptake, differential renal perfusion, drainage patterns, and estimated split renal function. Images and report are routed to the referring urologist or nephrologist for clinical correlation and treatment planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation/report for the nuclear medicine study separate from technical components |