Summary & Overview
HCPCS A9584: Iodine 1-123 Ioflupane Diagnostic Study Dose
HCPCS Level II code A9584 denotes Iodine 1-123 ioflupane supplied for a diagnostic study dose up to 5 millicuries. This radiotracer is central to nuclear medicine imaging that evaluates the brain's presynaptic dopamine transporter system, informing diagnoses such as Parkinsonian syndromes and other movement disorders. As a radiopharmaceutical supply code, A9584 is billed alongside imaging procedure codes and is relevant to both clinical workflows and coverage determinations across payers.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise view of coverage patterns, coding and billing considerations, and clinical context affecting utilization of Iodine 1-123 ioflupane. Readers will find benchmarks for use and reimbursement practices, summary guidance on how the code is typically paired with imaging procedure codes and sites of service, and notes on recent policy or coding clarifications where applicable. Data not available in the input is identified as such where necessary.
This summary is intended for billing professionals, practice administrators, and imaging clinicians seeking a practical reference for how HCPCS Level II code A9584 is used in diagnostic nuclear medicine services nationwide.
Billing Code Overview
HCPCS Level II code A9584 represents Iodine 1-123 ioflupane supplied for diagnostic imaging, billed per study dose, up to 5 millicuries. This radiopharmaceutical is used in nuclear medicine studies that image the brain's dopamine transporter system.
Service type: Radiopharmaceutical diagnostic supply
Typical site of service: Outpatient imaging centers or hospital nuclear medicine departments
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive parkinsonian symptoms (resting tremor, bradykinesia, rigidity) is referred to nuclear medicine to undergo an imaging study using Iodine 1-123 ioflupane for evaluation of presynaptic dopaminergic neuron integrity. The facility verifies patient identity, checks for contraindications (pregnancy, breastfeeding), reviews medications that interfere with tracer uptake (e.g., bupropion, selective serotonin reuptake inhibitors, certain antihypertensives), and obtains informed consent. The radiopharmacy prepares a study dose up to 5 millicuries of Iodine 1-123 ioflupane per kit instructions. The patient arrives to the nuclear medicine suite, vital signs are assessed, and the tracer is administered intravenously. After an uptake period (typically 3–6 hours per institutional protocol), single-photon emission computed tomography (SPECT) images of the brain are acquired. Images are processed and interpreted by a nuclear medicine physician or radiologist to assist in differentiating Parkinson disease from other causes of parkinsonism. The final report documents dose administered, lot number, imaging times, and diagnostic impression. Billing uses HCPCS Level II code A9584 for the radiopharmaceutical dose; separate billing may apply for SPECT imaging and professional interpretation using appropriate CPT codes.
Coding Specifications
| Modifier | Description | When to Use |
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