Summary & Overview
HCPCS Level II A9575: Injection, Gadoterate Meglumine, 0.1 ml
HCPCS Level II code A9575 denotes a unit of gadoterate meglumine injection measured at 0.1 ml, used as a gadolinium-based contrast agent for magnetic resonance imaging. This code matters nationally because contrast media account for routine, billable supplies in diagnostic imaging workflows and can affect imaging costs, prior authorization practices, and supply-chain management across payers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for contrast use in MRI, typical sites of service such as imaging centers and hospital outpatient departments, and the kinds of benchmarks and policy considerations commonly associated with contrast agent billing (unitization, unit reporting, and coverage policy triggers). The publication also highlights where input data is unavailable and flags common areas for payer policy variation, including prior authorization and medical necessity reviews.
The report does not provide clinical recommendations. Instead, it supplies operational and billing-focused information: what the code represents, how it is typically used in imaging services, payers commonly involved in coverage decisions, and the types of benchmarks and policy updates readers can expect to encounter when managing billing for contrast agents in MRI.
Billing Code Overview
HCPCS Level II code A9575 represents an injection of gadoterate meglumine, billed per 0.1 ml. This product is a gadolinium-based contrast agent used to enhance magnetic resonance imaging (MRI) studies.
Service Type: Contrast agent administration for MRI
Typical Site of Service: Imaging centers, hospital outpatient departments, and radiology suites
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with worsening neurological symptoms (new focal deficits and progressive headaches) is scheduled for a contrast-enhanced MRI of the brain to evaluate for an intracranial mass or metastasis. The imaging order specifies use of gadoterate meglumine as the gadolinium-based contrast agent. At the outpatient imaging center, nursing reviews allergies and renal function (serum creatinine, eGFR). The technologist establishes IV access, the radiologist or MRI technologist administers the contrast intravenously using a syringe or power injector, and the dose is documented in milliliters and milligrams. The HCPCS Level II code A9575 (Injection, gadoterate meglumine, 0.1 ml) is used to report the contrast agent in addition to the MRI procedure code. Post‑procedure monitoring for adverse reactions occurs for a brief period before the patient is discharged to home or transferred to the inpatient unit if applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | When the contrast injection is billed separately from another procedure on the same day that is not normally reported together |
76* |