Summary & Overview

HCPCS Q9967: Low Osmolar Iodinated Contrast, 300-399 mg/ml

HCPCS Level II code Q9967 designates low osmolar iodinated contrast media with an iodine concentration of 300–399 mg/ml, billed per milliliter. This supply code is used nationally for contrast-enhanced imaging procedures such as CT angiography, vascular studies, and other intravascular diagnostic imaging where moderate-to-high iodine concentration is required. It matters because contrast media represent a recurring, material cost in imaging workflows and influence overall imaging episode cost and coding accuracy.

Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use of this concentration range, common billing practices, and the payer landscape affecting reimbursement and coverage. The publication also covers benchmarks for utilization and unit reporting, practical coding considerations for supply-level billing, and any recent policy updates that affect HCPCS Level II coding for contrast agents.

This summary serves clinicians, billing staff, and policy analysts seeking a national-level reference for HCPCS Level II code Q9967, including when the product is commonly used and which payers typically cover contrast material claims.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ9967HCPCS Level IIcontrast mediaradiology suppliesimagingCT angiographydiagnostic imaginglow osmolar contrastiodine concentration

Billing Code Overview

HCPCS Level II code Q9967 describes low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml. This code represents a radiology supply item used to provide iodinated intravascular contrast for diagnostic imaging studies. The primary service type associated with this code is contrast media administration for diagnostic imaging, and the typical site of service is hospital outpatient departments, imaging centers, and radiology suites where contrast-enhanced CT, angiography, or other vascular imaging procedures are performed.

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Clinical & Coding Specifications

Clinical Context

A 62-year-old outpatient with a history of peripheral arterial disease is scheduled for a CT angiography of the abdomen and pelvis to evaluate suspected renal artery stenosis and evaluate vascular anatomy before planned revascularization. An intravenous peripheral catheter is placed in the radiology suite, and the patient receives low osmolar iodinated contrast material with an iodine concentration in the 300–399 mg/mL range billed as Q9967 per milliliter. The technologist documents the volume administered, lot number, and patient allergies; the radiologist performs the contrast-enhanced CT acquisition, interprets the study, and documents contrast type and dose in the report. Typical indications include vascular imaging (CT angiography), contrast-enhanced CT for oncologic staging, and evaluation of suspected infection or inflammation where iodinated contrast improves diagnostic yield. Typical site of service is an outpatient radiology imaging center or hospital outpatient department; this contrast agent is also commonly used in inpatient imaging and interventional radiology procedures when moderate-to-high iodine concentration is required.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing separately for the physician interpretation of imaging when technical component is billed by facility.
`50`	Bilateral procedure	Use when identical contrast-enhanced studies are performed bilaterally and payer requires modifier for bilateral reporting.
`51`	Multiple procedures	Use when contrast administration occurs with multiple distinct procedures performed during the same encounter and payer requires multiple-procedure reporting.
`52`	Reduced services	Use when the full volume of contrast is not administered due to clinical reasons (e.g., adverse reaction) and service is reduced.
`53`	Discontinued procedure	Use when contrast administration or the imaging procedure is started but discontinued for patient safety reasons.
`59`	Distinct procedural service	Use to indicate a distinct procedure or separate encounter when multiple services might be bundled by payer policy.
`76`	Repeat procedure by same physician	Use when the contrast-enhanced study is repeated the same day by the same physician.
`77`	Repeat procedure by another physician	Use when the same contrast-enhanced study is repeated by a different physician.
`91`	Repeat clinical diagnostic laboratory test	Use when a repeat imaging contrast administration is performed to repeat a diagnostic acquisition for comparison or technical failure (some payers use for repeat contrast dosing).
`JW`	Drug/biological discarded unused portion	Use when documentation shows that part of the contrast vial was discarded and payer requires reporting of discarded portion.
`QW`	CLIA waived test	Not typically applicable to contrast but included on payer lists when lab-related reporting is needed; rarely used for contrast agents.
`GA`	Waiver of liability statement on file	Use when patient has signed ABN-like acknowledgement for an item denied by payer and billing requires proof of voluntary financial responsibility.
`GZ`	Item or service expected to be denied as not reasonable and necessary	Use when provider documents medical necessity but service is expected to be denied and modifier is required by payer.
`KX`	Requirements specified in medical policy are met	Use when payer requires attestation that specific clinical criteria were met for contrast use per local medical policy.

Taxonomy Code	Specialty	Notes
`2085R0201X`	Diagnostic Radiology	Radiologists order, interpret, and oversee contrast-enhanced imaging and documentation.
`207K00000X`	Interventional Radiology	Interventional radiologists perform procedures requiring iodinated contrast for angiography and interventions.
`2084P0800X`	Diagnostic Radiology - Vascular & Interventional	Vascular imaging and intervention specialists who utilize contrast for angiographic procedures.
`261Q13000X`	Emergency Medicine	Emergency physicians frequently request contrast-enhanced CT in acute abdominal, chest, or trauma evaluations.
`207L00000X`	Nuclear Medicine	Nuclear medicine physicians may be involved when combined diagnostic protocols require contrast-enhanced CT for attenuation correction or localization.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Indication for CT angiography using iodinated contrast to assess arterial stenosis or occlusion.
`N28.0`	Acute kidney failure	Consideration for contrast use requires risk assessment; low osmolar agents like `Q9967` are often selected when renal function permits.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Contrast-enhanced CT of the abdomen with `Q9967` for staging and lesion characterization.
`K35.80`	Unspecified acute appendicitis	Contrast-enhanced CT of the abdomen may be used to diagnose appendicitis and complications.
`J18.9`	Pneumonia, unspecified organism	Contrast-enhanced chest CT may be performed for complicated infection evaluation; contrast aids in abscess and vascular complication detection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71260`	CT chest with contrast, single or multiple phases	Common contrast-enhanced CT study where `Q9967` iodinated contrast is administered for vascular and parenchymal assessment.
`74177`	CT abdomen and pelvis with contrast, single or multiple phases	Frequent use of low osmolar contrast `Q9967` for oncologic staging, infection, and vascular evaluation.
`72081`	CT lower extremity, unilateral, with contrast for angiography	Uses iodinated contrast for CT angiography of peripheral vasculature; contrast billed separately as `Q9967`.
`75635`	CT angiography, abdominal, non-coronary, with contrast material	Directly involves iodinated contrast administration for vascular lumen assessment; `Q9967` is appropriate product coding.
`93975`	Duplex scan of extremity veins noninvasive testing	Non-contrast ultrasound alternative often performed alongside or instead of contrast CT; relevant in vascular workups though does not use `Q9967`.