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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.

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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.

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HCPCS A9606: Radium ra-223 dichloride, therapeutic, per microcurie

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Get alerted when payer policies referencing A9606 are released or updated.

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Billing Code Overview

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`	Unspecified	Rarely used; placeholder when no other modifier applies
`11`	Emergency	When the service is rendered in an emergency situation
`22`	Increased procedural services	When significantly greater than usual service is required (e.g., prolonged monitoring for adverse reaction)
`23`	Unusual anesthesia	When anesthesia is medically necessary but not typically used for radium-223 administration
`26`	Professional component	When billing only the physician professional component separate from facility/radiopharmacy
`52`	Reduced services	When a planned full dose or service is partially reduced (e.g., dose reduced for low blood counts)
`53`	Discontinued service	If administration is started but discontinued due to an acute reaction before completion
`62`	Two surgeons	Rarely applicable; used if two physicians of same specialty share complex procedural responsibility
`78`	Return to OR following surgery	Not typically used; included for completeness if related procedural return required
`80`	Assistant surgeon	If an assistant surgeon participates in a related invasive procedure
`82`	Assistant surgeon (when qualified resident surgeon not available)	Similar to `80` when applicable
`CQ`	Service furnished to a beneficiary enrolled in a Medicare Part C plan	When patient is enrolled in Medicare Advantage plan and specific reporting is required
`JW`	Drug amount discarded/not administered to any patient	When a portion of the prepared radium-223 is discarded and must be reported for billing accuracy
`JZ`	No drug administered	When the drug was not administered and documentation supports this status

Taxonomy Code	Specialty	Notes
207RP0219X	Radiation Oncology	Primary specialty delivering radium-223 therapy and overseeing patient management
208000000X	Nuclear Medicine	Prepares and administers radiopharmaceuticals; radiation safety oversight
207L00000X	Medical Oncology	Referring and coordinating systemic therapy and overall cancer care
363A00000X	Nursing — Oncology	Infusion nursing and patient monitoring during and after administration
174400000X	Pharmacist	Radiopharmacy compounding, dose calculation, and safe handling of radiopharmaceuticals

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C79.51`	Secondary malignant neoplasm of bone	Primary indication for radium-223 treatment for symptomatic bone metastases
`C61`	Malignant neoplasm of prostate	Underlying primary malignancy for which radium-223 is commonly indicated in metastatic castration-resistant disease
`D70.9`	Neutropenia, unspecified	Laboratory finding that may influence dosing or delay administration due to hematologic risk
`D61.8`	Other specified aplastic anemias and other bone marrow failure syndromes	Hematologic contraindication or consideration for dose modification or withholding therapy
`M54.5`	Low back pain	Symptom commonly reported by patients with painful bone metastases; relevant to symptomatic benefit assessment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, therapeutic, initial, up to 1 hour	Use for billing IV administration time if facility requires infusion CPT coding for drug administration supervision; sometimes used for therapeutic infusions when applicable
`96413`	Chemotherapy administration, IV infusion technique; up to 1 hour, single or initial substance/drug	May be used in oncology settings to capture chemotherapy infusion administration workflow when applicable to radiopharmaceutical infusion billing practices
`96417`	Chemotherapy administration, additional hour	For prolonged observation or extended infusion/monitoring time beyond the initial hour when clinically required
`77012`	Radiotherapy dose planning — simple	Associated radiotherapy planning codes sometimes billed in parallel care coordination for patients receiving combination external beam treatments
`77427`	Radiation treatment management, 5 treatments	Used when radiation oncologist provides treatment management services during a course of radiation therapy that may coincide with radium-223 care coordination

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, Per Dose

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 A9155: Artificial Saliva, 30 ml

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

HCPCS 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 A9268: Programmer for Transient Orally Ingested Capsule

HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

HCPCS A9269: Programmable Transient Orally Ingested Capsule, Monthly

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

HCPCS Level II A9270: Non-covered Item or Service

Showing 1–10 of 138

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Unspecified	Rarely used; placeholder when no other modifier applies
`11`	Emergency	When the service is rendered in an emergency situation
`22`	Increased procedural services	When significantly greater than usual service is required (e.g., prolonged monitoring for adverse reaction)
`23`	Unusual anesthesia	When anesthesia is medically necessary but not typically used for radium-223 administration
`26`	Professional component	When billing only the physician professional component separate from facility/radiopharmacy
`52`	Reduced services	When a planned full dose or service is partially reduced (e.g., dose reduced for low blood counts)
`53`	Discontinued service	If administration is started but discontinued due to an acute reaction before completion
`62`	Two surgeons	Rarely applicable; used if two physicians of same specialty share complex procedural responsibility
`78`	Return to OR following surgery	Not typically used; included for completeness if related procedural return required
`80`	Assistant surgeon	If an assistant surgeon participates in a related invasive procedure
`82`	Assistant surgeon (when qualified resident surgeon not available)	Similar to `80` when applicable
`CQ`	Service furnished to a beneficiary enrolled in a Medicare Part C plan	When patient is enrolled in Medicare Advantage plan and specific reporting is required
`JW`	Drug amount discarded/not administered to any patient	When a portion of the prepared radium-223 is discarded and must be reported for billing accuracy
`JZ`	No drug administered	When the drug was not administered and documentation supports this status

Taxonomy Code	Specialty	Notes
207RP0219X	Radiation Oncology	Primary specialty delivering radium-223 therapy and overseeing patient management
208000000X	Nuclear Medicine	Prepares and administers radiopharmaceuticals; radiation safety oversight
207L00000X	Medical Oncology	Referring and coordinating systemic therapy and overall cancer care
363A00000X	Nursing — Oncology	Infusion nursing and patient monitoring during and after administration
174400000X	Pharmacist	Radiopharmacy compounding, dose calculation, and safe handling of radiopharmaceuticals

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C79.51`	Secondary malignant neoplasm of bone	Primary indication for radium-223 treatment for symptomatic bone metastases
`C61`	Malignant neoplasm of prostate	Underlying primary malignancy for which radium-223 is commonly indicated in metastatic castration-resistant disease
`D70.9`	Neutropenia, unspecified	Laboratory finding that may influence dosing or delay administration due to hematologic risk
`D61.8`	Other specified aplastic anemias and other bone marrow failure syndromes	Hematologic contraindication or consideration for dose modification or withholding therapy
`M54.5`	Low back pain	Symptom commonly reported by patients with painful bone metastases; relevant to symptomatic benefit assessment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, therapeutic, initial, up to 1 hour	Use for billing IV administration time if facility requires infusion CPT coding for drug administration supervision; sometimes used for therapeutic infusions when applicable
`96413`	Chemotherapy administration, IV infusion technique; up to 1 hour, single or initial substance/drug	May be used in oncology settings to capture chemotherapy infusion administration workflow when applicable to radiopharmaceutical infusion billing practices
`96417`	Chemotherapy administration, additional hour	For prolonged observation or extended infusion/monitoring time beyond the initial hour when clinically required
`77012`	Radiotherapy dose planning — simple	Associated radiotherapy planning codes sometimes billed in parallel care coordination for patients receiving combination external beam treatments
`77427`	Radiation treatment management, 5 treatments	Used when radiation oncologist provides treatment management services during a course of radiation therapy that may coincide with radium-223 care coordination

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, Per Dose

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 A9155: Artificial Saliva, 30 ml

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

HCPCS 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 A9268: Programmer for Transient Orally Ingested Capsule

HCPCS-A9269-PROGRAMMABLE-TRANSIENT-ORAL-CAPSULE

HCPCS A9269: Programmable Transient Orally Ingested Capsule, Monthly

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

HCPCS Level II A9270: Non-covered Item or Service

Showing 1–10 of 138

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.