C9150 Xenon Xe-129 HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS C9150: Xenon Xe-129 Hyperpolarized Gas, Diagnostic, Per Study Dose

HCPCS Level II code C9150 designates Xenon Xe-129 hyperpolarized gas provided as a diagnostic, per-study dose for pulmonary imaging. This emerging imaging agent supports advanced MRI and functional lung assessments by enhancing visualization of ventilation and regional gas distribution. Nationally, the code matters as centers adopt novel imaging approaches for obstructive and interstitial lung disease, research protocols, and precision evaluation of ventilation heterogeneity.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for hyperpolarized gas MRI, implementation considerations for imaging sites, and what payers typically consider when covering diagnostic inhaled agents. The publication summarizes benchmarks where available, highlights relevant policy and coding updates, and clarifies common billing elements associated with the service line.

This summary is intended for health policy analysts, revenue cycle managers, radiology and pulmonary service leaders, and payers seeking a national-level view of the code's clinical use and administrative considerations. Data not available in the input for associated taxonomies, ICD-10 pairings, and payer-specific reimbursement rates.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareC9150HCPCS Level IIhyperpolarized gaspulmonary imagingdiagnostic imaging agentMRI ventilationradiology billingfunctional lung assessmenthospital outpatient imaging

Billing Code Overview

HCPCS Level II code C9150 describes Xenon Xe-129 hyperpolarized gas, diagnostic, per study dose. This code represents a diagnostic radiology agent used as a contrast or inhaled tracer for pulmonary imaging and functional lung assessment.

Service Type: Diagnostic imaging agent, inhaled hyperpolarized gas study

Typical Site of Service: Hospital outpatient radiology departments, outpatient imaging centers, and specialized pulmonary function or research imaging suites

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient with unexplained persistent dyspnea and suspected regional ventilation defects is referred for advanced pulmonary imaging using hyperpolarized xenon-129 gas MRI. Typical patients include adults with interstitial lung disease, chronic obstructive pulmonary disease with disproportionate symptoms, or long COVID with persistent breathlessness despite normal chest radiography. The clinical workflow: the patient undergoes pre-procedure screening for MRI compatibility and contraindications; informed consent is obtained for inhalation of Xenon Xe-129 hyperpolarized gas for diagnostic imaging. On the day of service, a respiratory therapist and MRI technologist prepare the study dose (C9150) and confirm monitoring equipment (pulse oximetry, blood pressure). The patient practices breath-hold maneuvers, then inhales the study dose under supervision and is positioned in the MRI scanner. Dynamic ventilation images are acquired during breath-hold and breathing sequences to assess regional ventilation, gas exchange, and alveolar-capillary transfer. Post-procedure monitoring ensures return to baseline oxygenation and vitals prior to discharge. The imaging findings are reviewed by a thoracic radiologist and communicated to the referring pulmonologist for integration into diagnosis and management planning.

Coding Specifications

Modifier	Description	When to Use
`22`

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Showing 1–10 of 603

Taxonomy Code	Specialty	Notes
`207RG0100X`	Radiology - Diagnostic Radiology	Thoracic radiologists performing interpretation of xenon-129 MRI.
`363L00000X`	Pulmonary Disease	Pulmonologists who refer, interpret clinical context, and use results for management.
`2084P0800X`	Nuclear Medicine	Specialists familiar with inhaled contrast gas imaging techniques and image acquisition.
`367500000X`	Respiratory Care Services	Respiratory therapists who administer inhalational study dose and monitor the patient.
`208000000X`	Diagnostic Radiology (General)	General radiologists involved in image acquisition and reporting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J84.10`	Pulmonary fibrosis, unspecified	Used when suspected interstitial lung disease requires regional ventilation assessment with xenon-129 MRI.
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Applicable for patients with COPD to evaluate heterogeneous ventilation and guide targeted therapies.
`R06.02`	Shortness of breath, orthopnea	Symptom code for patients with unexplained dyspnea undergoing advanced ventilation imaging.
`R06.02`	Dyspnea, unspecified	(Note: `R06.02` and `R06.00` are common; include most relevant) Evaluation of persistent breathlessness prompting xenon MRI.
`U09.9`	Post COVID-19 condition, unspecified	Used for patients with long COVID and persistent respiratory symptoms to assess ventilation abnormalities.
`J98.4`	Other disorders of lung, not elsewhere classified	For atypical or undifferentiated pulmonary conditions requiring advanced imaging.
`R06.02`	Abnormal breathing	Represents symptomatic indications for ventilation imaging.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71260`	CT thorax, without contrast, diagnostic; single or multiple studies	May be performed before or after xenon MRI to evaluate structural lung disease complementary to ventilation imaging.
`71271`	CT thorax, with contrast, diagnostic; single or multiple studies	Performed when vascular evaluation or enhanced parenchymal assessment is required in conjunction with ventilation imaging.
`94010`	Breathing capacity test (spirometry)	Pre- and post-procedure pulmonary function testing often performed to correlate regional ventilation findings from xenon MRI.
`94640`	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	Represents inhalation therapies that may be used in the clinical setting but not for the imaging agent; included for workflow context when bronchodilator testing is paired.
`94070`	Bronchospasm evaluation; spirometry with bronchodilator	May be performed alongside to evaluate reversible airway obstruction related to imaging findings.