Summary & Overview
HCPCS Q9955: Perflexane Lipid Microspheres Injection, per mL
HCPCS Level II code Q9955 designates the per-milliliter unit for injection of perflexane lipid microspheres, a contrast agent used for intravascular enhancement during imaging studies. Nationwide, accurate coding for contrast agents affects billing precision, reimbursement, and imaging workflow documentation, particularly for facilities that frequently perform advanced vascular or organ perfusion imaging.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical sites of service, and the clinical context for use. The publication summarizes common billing and documentation considerations, presents payer coverage patterns where available, and outlines relevant benchmarking points for facility and professional service lines.
The report is intended to inform billing staff, radiology administrators, and revenue cycle teams about the operational implications of coding with Q9955, including how units are recorded on service lines and where this code typically appears in outpatient and hospital-based imaging claims. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code Q9955 describes an injection of perflexane lipid microspheres, per milliliter. The code represents the billed unit for administration of a lipid microsphere contrast agent commonly used in imaging procedures that require intravascular contrast enhancement.
Service type: Contrast agent administration
Typical site of service: Outpatient imaging centers, hospital radiology departments, and ambulatory surgical centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient presents for intravascular contrast-enhanced ultrasound or specialized imaging where a lipid microsphere ultrasound contrast agent, perflexane, is required to improve visualization of vascular structures or organ perfusion. Typical patients are adults undergoing echocardiography with suboptimal acoustic windows, hepatic ultrasound for lesion characterization, or vascular ultrasound when enhanced delineation of blood flow or microvascular perfusion is clinically indicated. The clinical workflow includes: pre-procedure verification of indication and allergies, informed consent, intravenous access placement, preparation and dosage calculation of Q9955 (perflexane lipid microspheres) per milliliter, administration by trained staff under direct physician oversight, real-time ultrasound imaging during and after injection, documentation of lot number and volume administered, monitoring for immediate adverse reactions for at least 30 minutes, and incorporation of imaging findings into the patient record for diagnostic or therapeutic planning. Typical site of service is outpatient imaging center, hospital radiology or cardiology department, or ambulatory surgical center depending on clinical context and monitoring needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component of an imaging study that used as contrast. |