Summary & Overview
HCPCS C9408: Iodine I-131 Iobenguane Therapeutic, 1 millicurie
HCPCS Level II code C9408 denotes a therapeutic radiopharmaceutical: iodine I-131 iobenguane, 1 millicurie. This code identifies a specific, low-activity unit dose used in targeted radionuclide therapy, typically administered in nuclear medicine or hospital outpatient therapy settings. As a specialized radiopharmaceutical, C9408 is relevant for oncology and endocrinology treatment pathways and for facilities that manage therapeutic radionuclide services.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national overview of clinical context and service settings, common billing considerations for a therapeutic radionuclide product, and how C9408 is classified within HCPCS Level II coding. The publication summarizes typical use cases, expected site-of-service patterns, and the types of reimbursement and billing areas stakeholders monitor for radiopharmaceutical therapies.
This summary provides clinicians, coding professionals, and revenue cycle managers with a concise reference to the code’s clinical meaning, where the service is typically delivered, and which major payers are commonly involved. Data not available in the input: specific modifiers, associated taxonomies, ICD-10 diagnoses, related codes, payer-specific coverage rules, and service-line level details.
Billing Code Overview
HCPCS Level II code C9408 represents Iodine I-131 iobenguane, therapeutic, 1 millicurie. This item is a radiopharmaceutical therapeutic dose of iobenguane labeled with iodine I-131 used in targeted radiotherapy.
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Service type: Therapeutic radiopharmaceutical administration
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Typical site of service: Nuclear medicine department or hospital outpatient infusion/therapy center
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with metastatic, norepinephrine transporter–expressing neuroendocrine tumor (such as pheochromocytoma/paraganglioma) is referred to nuclear medicine for targeted radiotherapeutic treatment with iodine I-131 iobenguane. The patient undergoes pre-therapy evaluation including review of prior imaging, antihypertensive optimization, and thyroid blockade with potassium iodide to protect normal thyroid tissue. On the day of therapy, intravenous administration of C9408 (iodine I-131 iobenguane, therapeutic, 1 millicurie) is performed in an inpatient or hospital outpatient nuclear medicine or radiation oncology infusion area with radiation safety precautions and monitoring. Post-infusion, the patient is observed for immediate adverse events, provided radiation safety instructions for home isolation or inpatient precautions, and scheduled for follow-up imaging and clinical assessment to evaluate treatment response and potential hematologic or adrenergic effects.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component provided by a physician for associated imaging or dosimetry |
TC |