Summary & Overview
HCPCS Level II Q9969: Tc-99m Non-HEU Cost Recovery, Per-Study Dose
HCPCS Level II code Q9969 denotes an add-on charge for technetium-99m (Tc-99m) produced from non-highly enriched uranium sources, billed on a per‑study dose basis to recover supplier cost differences. The code matters nationally as the supply chain for radiopharmaceuticals shifts toward low‑enriched sources for nonproliferation and manufacturing reasons; payers and providers must account for discrete add-on charges tied to specific radiopharmaceutical sourcing. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare.
Readers will learn what the code represents, where it is used clinically, and which payers commonly cover the add-on. The publication summarizes national benchmarking context, outlines typical sites of service (hospital outpatient departments and ambulatory imaging centers), and highlights billing considerations related to per‑study dose add-on charges. Data limitations are noted when input fields are not provided. This summary is intended to inform revenue cycle, clinical operations, and payer policy teams about the presence and purpose of Q9969 in billing for Tc‑99m nuclear medicine studies.
Billing Code Overview
HCPCS Level II code Q9969 represents Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose. This code applies to the radiopharmaceutical component of nuclear medicine studies using technetium-99m derived from low-enriched or non-highly enriched uranium production sources, and is billed as an add-on to the per-study dose to recover supplier cost differentials.
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Service type: Radiopharmaceutical supply for nuclear medicine diagnostic studies
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Typical site of service: Hospital outpatient departments, ambulatory imaging centers, and other outpatient nuclear medicine facilities
Clinical & Coding Specifications
Clinical Context
A patient referred for a nuclear medicine study (for example, a myocardial perfusion imaging study or bone scan) receives a radiopharmaceutical dose of technetium-99m (Tc-99m) supplied from a non-highly enriched uranium (non-HEU) source. The technologist verifies identity and informed consent, prepares and administers the Tc-99m dose per protocol, and documents lot number and activity. The billing team appends Q9969 as the full cost recovery add-on charge per study dose for Tc-99m from a non-HEU source. Typical workflow: order placed by a nuclear medicine or cardiology provider → scheduling and pre-procedure screening → radiopharmacy receives and documents non-HEU Tc-99m supply → dose preparation and quality control → patient arrival, IV placement, and injection → imaging acquisition by nuclear medicine technologist → image interpretation by nuclear medicine physician or cardiologist → charge capture including radiopharmaceutical base code(s) and the Q9969 add-on per administered study dose.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service |