A9698 Non-Radioactive Contrast HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS A9698: Non-Radioactive Contrast Imaging Material, Per Study

HCPCS Level II code A9698 identifies non-radioactive contrast imaging material used on a per-study basis when no specific HCPCS code applies. This designation is important for billing clarity and reimbursement for contrast agents that lack a more specific product-level code. Nationwide, accurate use of A9698 affects claim processing for outpatient imaging services at hospitals, ambulatory imaging centers, and other diagnostic settings.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role, typical sites of service, and how it is applied in claims. The publication outlines common billing modifiers associated with contrast administration (listed in the metadata) and notes where data is not available in the input. It also summarizes policy and coverage considerations relevant to payers and highlights areas where coders and billing staff should confirm payer-specific guidance.

This brief provides national context rather than state-level rules, enabling providers and billing professionals to understand when A9698 is used, which payers commonly encounter it, and what supporting information is typically required for claim adjudication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA9698HCPCS Level IIcontrast mediadiagnostic imagingoutpatient imagingbillingreimbursementmedical coding

Billing Code Overview

HCPCS Level II code A9698 describes non-radioactive contrast imaging material, not otherwise classified, per study. This code covers contrast agents used to enhance imaging studies when the product does not fit a more specific HCPCS descriptor.

Service type: Imaging contrast agent administration for diagnostic imaging studies
Typical site of service: Hospital outpatient departments, ambulatory imaging centers, and other outpatient diagnostic settings

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult referred for a specialized imaging study requiring a non-radioactive contrast agent not otherwise classified, billed with A9698. Example scenario: a 58-year-old patient with chronic peripheral arterial disease and severe iodinated-contrast allergy undergoes non-iodinated, non-radioactive contrast-enhanced vascular imaging (for example, CO2 or gadolinium alternatives used off-label for peripheral angiography) to evaluate limb ischemia. The workflow includes pre-procedure assessment (allergy review, renal function evaluation), informed consent, intravenous or intra-arterial administration of the non-radioactive contrast per institutional protocol, real-time fluoroscopic or digital subtraction angiography acquisition, immediate post-procedure monitoring for adverse reactions, and documentation of the specific agent and volume used. Typical indications include diagnostic vascular studies when standard iodinated contrast is contraindicated, endovascular procedure planning, or follow-up imaging when MRI contrast cannot be used. Typical site of service is an outpatient hospital radiology suite, ambulatory surgical center, or an inpatient interventional radiology or vascular surgery suite depending on acuity and setting.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to administer the contrast is substantially greater than typical (document justification).

HCPCS A9699: Radiopharmaceutical, Therapeutic, Not Otherwise Classified

HCPCS-A9540-TECHNETIUM-TC-99M-MACROAGGREGATED-ALBUMIN-LUNG-PERFUSION

HCPCS A9540: Technetium Tc-99m MAA for Lung Perfusion Imaging

HCPCS-A9281-REACHING-GRABBING-DEVICE-ASSISTIVE-REACHER

HCPCS A9281: Reaching/Grabbing Device, Assistive Reacher

HCPCS-A9606-RADIUM-RA-223-THERAPEUTIC-PER-MICROCURIE

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

HCPCS-A9559-COBALT-CO57-CYANOCOBALAMIN-ORAL-DIAGNOSTIC

HCPCS A9559: Cobalt Co-57 Cyanocobalamin Oral Diagnostic Dose

HCPCS-A9581-GADOXETATE-DISODIUM-INJECTION-1ML

HCPCS A9581: Gadoxetate Disodium Injection, 1 ml

HCPCS-A9562-TECHNETIUM-TC-99M-MERTIATIDE-RENAL-IMAGING

HCPCS A9562: Technetium tc-99m Mertiatide, Diagnostic, Up to 15 mCi

HCPCS-A9607-LUTETIUM-LU-177-VIPIVOTIDE-TETRAXETAN-THERAPEUTIC

HCPCS A9607: Lutetium Lu 177 Vipivotide Tetraxetan, Therapeutic, 1 mCi

HCPCS-A9592-COPPER-CU64-DOTATATE-DIAGNOSTIC-1-MILLICURIE

HCPCS A9592: Copper Cu-64 Dotatate Diagnostic, 1 Millicurie

HCPCS-A9572-INDIUM-IN-111-PENTETREOTIDE-DIAGNOSTIC

HCPCS A9572: Indium In-111 Pentetreotide, Diagnostic, Per Study Dose

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Taxonomy Code	Specialty	Notes
`207P00000X`	Interventional Radiology	Commonly performs contrast-enhanced vascular studies and administers alternative contrast agents.
`208100000X`	Diagnostic Radiology	Interprets imaging studies using non-radioactive contrast agents.
`207L00000X`	Vascular Surgery	Performs and interprets intraoperative or endovascular studies using contrast.
`363A00000X`	Anesthesiology	Provides procedural sedation or anesthesia for longer or complex contrast-enhanced procedures.
`367500000X`	Physician Assistant	Assists with procedure setup, administration, and monitoring when allowed by state law.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.21`	Atherosclerosis of native arteries of extremities, with intermittent claudication	Common indication for peripheral angiography using alternative contrast when iodinated agents are contraindicated.
`I80.1`	Phlebitis and thrombophlebitis of femoral vein	May prompt contrast imaging to assess venous patency or guide intervention when standard contrast is unsuitable.
`N18.4`	Chronic kidney disease, stage 4 (severe)	Severe renal impairment is a common reason to avoid iodinated contrast and select non-radioactive alternatives.
`T78.01XA`	Anaphylactic reaction due to food, initial encounter	Prior anaphylaxis to iodinated contrast or other agents necessitates alternative non-radioactive contrast strategies.
`K55.9`	Vascular disorder of intestine, unspecified	Vascular evaluation with alternative contrast agents may be required when iodinated contrast poses risk.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`75625`	Angiography, extremity, bilateral, radiological supervision and interpretation	Often performed with non-radioactive contrast administration for diagnostic peripheral angiography studies.
`75710`	Angiography, abdominal aorta; radiological supervision and interpretation	May be paired when non-iodinated contrast is used for abdominal vascular evaluation.
`93880`	Duplex scan of extremity veins including responses to compression and other maneuvers, complete bilateral study	Performed before or after contrast-enhanced angiography for complementary vascular assessment (non-contrast ultrasound).
`93975`	Duplex scan of arterial inflow and venous outflow, lower extremity veins, bilateral	Provides non-contrast physiologic information often used in the diagnostic pathway with contrast studies.
`76937`	Ultrasound guidance for vascular access (e.g., for intra-arterial contrast administration)	Commonly used immediately before intra-arterial administration of non-radioactive contrast to guide vascular access.

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