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    v1.0.28
    OpenPayerBilling CodesAdministrative, Miscellaneous and InvestigationalHCPCS hcpcs-a9598-pet-radiopharmaceutical-non-tumor-diagnostic
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    HCPCS A9598: PET Radiopharmaceutical for Non-Tumor Diagnostic

    HCPCS Level II code A9598 describes a diagnostic positron emission tomography (PET) radiopharmaceutical product used for non-tumor identification studies; the service represents administration of a PET radiotracer for diagnostic imaging typically performed in outpatient imaging centers or hospital radiology/nuclear medicine departments to evaluate non-oncologic conditions.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with a history of neurodegenerative symptoms is referred for a diagnostic positron emission tomography (PET) radiopharmaceutical scan for non-tumor brain pathology evaluation. The referring neurologist documents progressive cognitive decline and atypical movement features to distinguish Alzheimer disease, Parkinson disease, or other parkinsonian syndromes. The patient arrives at an outpatient nuclear medicine department. Verification of identity, allergy history, medication review (including recent contrast or radiopharmaceutical exposures), and informed consent are completed. The nuclear medicine technologist administers the appropriate PET radiopharmaceutical designated for non-tumor brain imaging. The patient rests for the uptake period, is positioned on the PET/CT scanner, and acquisition is performed according to protocol. A radiopharmacist documents lot and dose; a nuclear medicine physician interprets the images and generates a report describing regional tracer distribution to aid differential diagnosis. Billing uses HCPCS Level II code A9598 for the radiopharmaceutical; professional and technical components may be billed separately using appropriate modifiers.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    78811Positron emission tomography (PET) imaging, limited area, single bed position; without concurrent CT for attenuation correction and anatomical localizationPerformed when a focused PET acquisition is appropriate for a limited brain region; may be billed when PET imaging is obtained without CT
    78812Positron emission tomography (PET) imaging, limited area, single bed position; with concurrent CT for attenuation correction and anatomical localizationPerformed when PET is acquired with CT for attenuation correction/anatomic localization of the non-tumor brain study
    78815Positron emission tomography (PET) imaging; whole body, single acquisition, without concurrent CT for attenuation correction and anatomical localizationUsed when broader PET coverage is required beyond the brain region
    78816Positron emission tomography (PET) imaging; whole body, single acquisition, with concurrent CT for attenuation correction and anatomical localizationUsed when whole-body PET with CT is clinically indicated in the same session
    0054TPET brain perfusion or receptor imaging, quantification and report (example for specialized PET brain studies)Used for advanced quantification or specialized research/diagnostic PET brain protocols when separate reporting code applies

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    246Q00000XPathology Specialist/Technologist(1) An individual educated and trained in clinical chemistry, microbiology or other biological sciences; and in gathering data on the blood, tissues, …
    2471B0102XBone Densitometry Radiologic TechnologistA radiologic technologist who specializes in bone densitometry and is appropriately educated and trained, consistent with nationally recognized standa…
    225XE1200XErgonomics Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Occupational Therapist
    163WW0000XWound Care Registered NurseNursing Service Providers · Registered Nurse

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-A9150-NON-PRESCRIPTION-DRUGS

    HCPCS Level II A9150: Non-prescription Drugs

    HCPCS-A9152-SINGLE-ORAL-VITAMIN-MINERAL-DOSE

    HCPCS A9152: Single Oral Vitamin/Mineral/Trace Element

    HCPCS-A9153-MULTIVITAMIN-ORAL-PER-DOSE

    HCPCS A9153: Multiple Vitamins, Oral, Per Dose

    HCPCS-A9154-ARTIFICIAL-SALIVA-1ML

    HCPCS Level II A9154: Artificial saliva, 1 ml

    HCPCS-A9155-ARTIFICIAL-SALIVA-30ML

    HCPCS Level II A9155: Artificial Saliva, 30 mL

    HCPCS-A9156-ORAL-MUCOADHESIVE-PER-1ML

    HCPCS Level II A9156: Oral Mucoadhesive, Per 1 ml

    HCPCS-A9180-PEDICULOSIS-TOPICAL-TREATMENT-PATIENT-ADMINISTRATION

    HCPCS Level II A9180: Pediculosis Topical Treatment for Patient/Caretaker

    HCPCS-A9268-PROGRAMMER-TRANSIENT-INGESTED-CAPSULE

    HCPCS Level II A9268: Programmer for Transient Orally Ingested Capsule

    HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

    HCPCS Level II A9269: Programmable Orally Ingested Capsule, Per Month

    HCPCS-A9270-NON-COVERED-ITEM-OR-SERVICE

    HCPCS A9270: Non-covered Item or Service

    Showing 1–10 of 138

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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