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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q9968-visualization-adjunct-injection-methylene-blue-1mg
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    HCPCS Level II Q9968: Visualization Adjunct Injection, 1 mg

    HCPCS Level II code Q9968 describes a 1 mg injection of a non-radioactive, non-contrast visualization adjunct (for example, methylene blue or isosulfan blue) used to aid intraoperative visualization; the service is an injectable diagnostic adjunct typically administered in an operating room or procedure suite to assist surgical localization and visualization during operative procedures.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A patient scheduled for sentinel lymph node mapping or intraoperative tissue localization during a surgical oncology or general surgery procedure receives an injection of a visualization adjunct such as methylene blue or isosulfan blue. Typical patients include adults undergoing breast cancer lumpectomy or biopsy with sentinel node mapping, melanoma wide local excision with lymphatic mapping, or gynecologic oncology cases requiring sentinel node identification. The injection is typically administered by the operating surgeon or an interventional radiologist in the operating room or procedure suite shortly before or at the start of the operative procedure. The visualization adjunct is injected intradermally, subdermally, or peritumorally in small volumes (measured by milligrams), and the surgical team observes lymphatic uptake or tissue staining to guide targeted dissection. The medication is supplied in a non-radioactive, non-contrast form and billed per milligram using Q9968. Documentation includes indication, site and route of injection, dose in mg, lot number, timed relation to the operative dissection, and any adverse reaction. Typical site of service: operating room, ambulatory surgery center, or procedure suite. Service type: intraoperative injectable visualization adjunct for tissue or lymphatic mapping.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    38525Biopsy or excision of lymph node(s); open, superficialMay be performed after visualization to remove sentinel lymph nodes identified by the adjunct dye.
    38900Intraoperative identification of sentinel node(s) using radiocolloid and/or blue dye; separate procedureOften reported alongside dye injection when sentinel node mapping is performed; relates directly to identification and biopsy of sentinel nodes.
    38530Biopsy or excision of deep lymph node(s) through separate incisionUsed when deeper nodal excision is required after mapping with the visualization adjunct.
    19301Mastectomy, partial (partial mastectomy, lumpectomy)Breast-conserving surgery commonly performed in conjunction with sentinel node mapping using blue dye.
    38999Unlisted procedure, hemic/lymphatic systemRarely used for novel or not otherwise classified intraoperative lymphatic mapping techniques when no specific CPT exists; documentation must justify use alongside Q9968.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    1835I0206XInfectious Diseases PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the use of microbiology and pharmacology to develop, implement, and moni…
    237600000XAudiologist-Hearing Aid FitterAn audiologist/hearing aid fitter is the professional who specializes in evaluating and treating people with hearing loss, conducts a wide variety of …
    170300000XGenetic Counselor (M.S.)A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; id…

    Related ICD-10-CM Codes

    15 rows

    ICD-10-CM CodeDescription
    C44.311Basal cell carcinoma of skin of nose
    C44.319Basal cell carcinoma of skin of other parts of face
    C50.112Malignant neoplasm of central portion of left female breast
    C50.212Malignant neoplasm of upper-inner quadrant of left female breast
    C50.411Malignant neoplasm of upper-outer quadrant of right female breast
    C50.612Malignant neoplasm of axillary tail of left female breast
    C50.911Malignant neoplasm of unspecified site of right female breast
    C50.912Malignant neoplasm of unspecified site of left female breast
    C50.919Malignant neoplasm of unspecified site of unspecified female breast
    C50.929Malignant neoplasm of unspecified site of unspecified male breast

    Showing 1–10 of 15

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV)blue cross blue shield - louisiana2026-09-15

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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