Summary & Overview
HCPCS A9563: Sodium Phosphate P-32 Therapeutic, Per Millicurie
HCPCS Level II code A9563 identifies sodium phosphate p-32 billed therapeutically per millicurie. This radiopharmaceutical is used in targeted internal radiation therapies where dosing is measured in millicuries. Nationally, accurate coding for radiotherapeutics matters for clinical tracking, billing integrity, and payer adjudication due to specialized handling, administration, and dosing requirements.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for this agent, typical sites of service, and the payer landscape addressed in benchmarking and coverage summaries. The publication outlines billing considerations specific to per-millicurie radiopharmaceuticals, common modifiers applicable to radiology and facility claims (listed elsewhere), and how payers commonly approach reimbursement and claim adjudication for therapeutic radiopharmaceuticals.
This piece provides operationally relevant benchmarks and policy updates where available, clarifies coding intent for clinical billing teams, and situates A9563 within radiopharmacy and nuclear medicine service lines. Data not available in the input is noted where applicable in detailed sections.
Billing Code Overview
HCPCS Level II code A9563 denotes sodium phosphate p-32, therapeutic, per millicurie. This code represents a radiopharmaceutical therapeutic agent measured and billed per millicurie for treatment purposes.
Service Type: Radiopharmaceutical therapy
Typical Site of Service: Hospital outpatient department or specialty nuclear medicine clinic
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of hyperthyroidism or a thyroid nodule refractory to medical therapy, referred to nuclear medicine for targeted radioisotope therapy. The treating team is commonly an endocrinologist or oncologist who documents indication, prior therapies, and informed consent. On the day of service the patient is evaluated in an outpatient nuclear medicine or hospital outpatient infusion suite. Baseline vitals and pregnancy status (where applicable) are confirmed. The nuclear medicine physician orders A9563 (sodium phosphate P-32, therapeutic, per millicurie) with the prescribed activity in millicuries. A radiopharmacy prepares the unit dose, verifies radioactivity, and performs appropriate labeling and radiation safety checks. The patient receives the dose orally or via the indicated route per protocol; staff monitor for immediate adverse reactions and provide post-therapy radiation safety and discharge instructions. Documentation includes indication, dose administered (millicurie), lot number, route, time of administration, consent, and any concurrent medications. Billing captures the per-millicurie charge using A9563 with appropriate modifiers to reflect unusual circumstances, multiple providers, or technical components as applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |