Summary & Overview
HCPCS S2095: Transcatheter Y-90 Radioembolization for Tumor Destruction
HCPCS Level II code S2095 represents transcatheter occlusion or embolization for tumor destruction using yttrium-90 microspheres, a targeted intra-arterial radiotherapeutic procedure commonly used for hepatic malignancies. The code captures percutaneous, catheter-based delivery of Y-90 microspheres for locoregional tumor control and is relevant to hospitals, interventional radiology departments, and specialty oncology centers nationally. Its use affects clinical pathways for patients with unresectable liver tumors and has implications for procedural authorization, facility billing, and payer coverage policies.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what S2095 represents, where the service is typically provided, and which major payers are relevant for coverage discussions. The publication provides benchmarks on payer coverage approaches, notes common modifier use where available, and summarizes clinical context for Y-90 radioembolization without offering clinical recommendations. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code S2095 describes transcatheter occlusion or embolization for tumor destruction, percutaneous, any method, using yttrium-90 microspheres. This service is an image-guided, catheter-directed intra-arterial therapy that delivers radioactive yttrium-90 microspheres to target hepatic tumors for local tumor control and destruction.
Service Type: Interventional radiology — transcatheter radioembolization (Y-90 microspheres)
Typical Site of Service: Hospital outpatient department or specialized interventional radiology suite
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with hepatocellular carcinoma (HCC) confined to the liver and not amenable to surgical resection is referred for locoregional therapy. Prior workup includes contrast-enhanced CT or MRI of the liver, multidisciplinary tumor board review, and assessment of liver function (Child-Pugh score), performance status, and portal vein patency. The interventional radiology team performs a pre-procedure angiographic mapping session to evaluate hepatic arterial anatomy and consider prophylactic embolization of extrahepatic branches. On the treatment day, under moderate sedation or general anesthesia in an angiography suite, arterial access is obtained (typically via common femoral or radial artery), selective catheterization of the hepatic artery is performed, and yttrium-90 microspheres are delivered through a microcatheter to the tumor-bearing hepatic arterial branch(es) to achieve transcatheter occlusion/embolization aimed at tumor destruction. Post-procedure recovery includes monitoring for post-embolization syndrome, targeted imaging follow-up (typically Tc-99m MAA or post-therapy bremsstrahlung/SPECT/CT or Y-90 PET/CT), and coordination with oncology for ongoing systemic therapy if indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the procedure requires substantially greater work than typical (unusual complexity or technical difficulty). |