Summary & Overview
HCPCS A9592: Copper Cu-64 Dotatate Diagnostic, 1 Millicurie
HCPCS Level II code A9592 identifies Copper Cu-64 dotatate, a radiopharmaceutical administered at a 1 millicurie dose for diagnostic PET imaging of somatostatin receptor–positive tumors. This code matters nationally as molecular imaging agents like Cu‑64 dotatate enable targeted diagnostic evaluation of neuroendocrine and other somatostatin-receptor–expressing malignancies, influencing care pathways and utilization of advanced imaging services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of coverage and reimbursement context, clinical purpose and typical care settings, and the operational considerations tied to radiopharmaceutical billing. The publication highlights benchmarks and policy-relevant points such as coding specificity for radiopharmaceuticals, payer coverage variability, and implications for site-of-service selection.
This summary is intended for administrators, coding professionals, and policy analysts seeking a clear, national-level briefing on HCPCS Level II code A9592, its clinical role in diagnostic PET imaging, and the payer landscape relevant to procurement and billing.
Billing Code Overview
HCPCS Level II code A9592 describes Copper Cu-64 dotatate, provided for diagnostic imaging, with the specified amount of 1 millicurie. This code represents a radiopharmaceutical agent used in nuclear medicine PET imaging to visualize somatostatin receptor–expressing tumors.
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Service type: Diagnostic radiopharmaceutical administration for PET imaging
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Typical site of service: Hospital outpatient imaging centers or freestanding imaging facilities equipped for PET radiotracer administration and scanning
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult being evaluated for suspected neuroendocrine tumor (NET) recurrence or metastatic disease. The patient presents with new or progressive symptoms such as flushing, diarrhea, abdominal pain, or unexplained weight loss and has prior imaging or biochemical markers suggestive of somatostatin receptor–expressing tumor. The clinical workflow includes referral from medical oncology or endocrinology to nuclear medicine or a radiology division for a PET/CT study using A9592 (Copper Cu-64, DOTATATE, diagnostic, 1 millicurie) as the radiopharmaceutical. On the day of service, the patient undergoes radiopharmaceutical administration per nuclear medicine protocols, a uptake period as specified by the imaging center, and PET/CT acquisition. Following image reconstruction and interpretation by a nuclear medicine physician or radiologist, a diagnostic report documents somatostatin receptor–avid lesions, compares with prior studies if available, and informs multidisciplinary care decisions such as peptide receptor radionuclide therapy candidacy or surgical planning. Typical sites of service are an outpatient hospital imaging center, freestanding imaging center, or academic medical center nuclear medicine department. The typical patient scenario may involve coordination of scheduling, pre-authorization for radiopharmaceuticals, and radiation safety procedures for handling Cu-64 DOTATATE.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |