Summary & Overview
HCPCS A9606: Radium ra-223 dichloride, therapeutic, per microcurie
HCPCS Level II code A9606 identifies radium ra-223 dichloride billed by microcurie for therapeutic use. Radium-223 is a targeted radiopharmaceutical indicated for treatment of certain metastatic bone conditions and is administered in controlled activity units; coding by microcurie reflects per-unit drug billing practices for high-cost radiopharmaceuticals. Nationally, correct use of A9606 affects facility reimbursement, drug inventory accounting, and claims processing for oncology and nuclear medicine services.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of how A9606 is classified and billed, the typical clinical and site-of-service contexts for administration, and the payer landscape that commonly adjudicates claims for radiopharmaceutical therapy. The publication outlines benchmarks and policy-relevant considerations such as unit-based drug billing, site-of-care implications, and documentation elements that influence coverage and payment decisions.
This summary provides a national overview suitable for health system administrators, revenue cycle managers, and clinical billing teams seeking to understand the role of A9606 in oncology and nuclear medicine service lines. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code A9606 denotes Radium ra-223 dichloride, therapeutic, per microcurie. This billing code represents a radiopharmaceutical therapy delivered in measured activity units (microcuries) used for therapeutic purposes.
Service type: Radiopharmaceutical therapeutic administration
Typical site of service: Hospital outpatient department, outpatient infusion center, or specialty cancer treatment center
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult male with metastatic castration-resistant prostate cancer (mCRPC) with symptomatic bone metastases and no known visceral metastases. The oncology team prescribes radium-223 dichloride for targeted alpha therapy. The patient is scheduled for outpatient infusion at a hospital-based infusion center or radiation oncology clinic with appropriate nuclear medicine handling. Pre-procedure workup includes oncology consultation, review of recent imaging (bone scan, CT or MRI to exclude visceral disease), baseline labs including complete blood count and renal function, and verification of performance status. On the day of service, the nuclear medicine or radiation oncology nurse verifies identity, obtains informed consent, confirms pregnancy status if applicable, and establishes IV access. The radiopharmacy prepares A9606 (radium ra-223 dichloride) dosed per microcurie, and the physician or authorized nuclear medicine/radiation oncologist documents dose, lot number, and time of administration. The agent is administered intravenously over a few minutes with radiation safety precautions and post-administration monitoring for acute reactions. Follow-up includes periodic blood counts, clinical assessment of bone pain and quality of life, and repeat imaging as clinically indicated. Typical sites of service are hospital outpatient departments, freestanding radiation oncology clinics, and specialized nuclear medicine infusion suites.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |