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Last Modified: 7/18/2024 Location: FL, PR, USVI Business: Part A, Part B

Radiopharmaceutical HCPCS codes no longer requiring a paper invoice (JN)

To reduce provider burden, certain contractor priced HCPCS codes no longer require a paper invoice.
When the invoice information is entered in the narrative field on a claim for any of the HCPCS codes listed below, it is not necessary to provide the actual paper invoice for these services. For details, view our article on the process for supplying invoice amount on certain HCPCS codes to avoid rejected claims.

Code
Description
Effective "from" date of service
Effective "through" date of service
A4642
Indium In-111 satumomab pendetide, diagnostic, per study dose up to 6 millicuries
1/1/2024
Present
A9501
Technetium Tc-99m teboroxime, diagnostic, per study dose
1/1/2024
Present
A9503
Technetium Tc-99m medronate, diagnostic, per study dose, up to 30 mCi
1/1/2024
Present
A9504
Technetium Tc-99m apcitide, diagnostic, per study dose, up to 20 mCi
1/1/2024
Present
A9507
Indium In-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries
1/1/2024
Present
A9508
Iodine I-131 iobenguane sulfate, diagnostic, per 0.5 mCi
1/1/2024
Present
A9509
Iodine I-123 sodium iodide, diagnostic, per mCi
1/1/2024
Present
A9510
Technetium Tc-99m disofenin, diagnostic, per study dose, up to 15 mCi
1/1/2024
Present
A9512
Technetium Tc-99m pertechnetate, diagnostic, per mCi
1/1/2024
Present
A9516
Iodine I-123 sodium iodide, diagnostic, per 100 mcCi, up to 999 mcCi
1/1/2024
Present
A9517
Iodine I-131 sodium iodide capsule(s), therapeutic, per mCi
1/1/2024
Present
A9526
Nitrogen N-13 ammonia, diagnostic, per study dose, up to 40 mCi
1/1/2024
Present
A9527
Iodine I-125, sodium iodide solution, therapeutic, per mCi
1/1/2024
Present
A9528
Iodine I-131 sodium iodide capsule(s), diagnostic, per mCi
1/1/2024
Present
A9529
Iodine I-131 sodium iodide solution, diagnostic, per mCi
1/1/2024
Present
A9530
Iodine I-131 sodium iodide solution, therapeutic, per mCi
1/1/2024
Present
A9531
Iodine I-131 sodium iodide, diagnostic, per mcCi (up to 100 mcCi)
1/1/2024
Present
A9532
Iodine I-125 serum albumin, diagnostic, per 5 mcCi
1/1/2024
Present
A9536
Technetium Tc-99m depreotide, diagnostic, per study dose, up to 35 mCi
1/1/2024
Present
A9538
Technetium Tc-99m pyrophosphate, diagnostic, per study dose, up to 25 mCi
1/1/2024
Present
A9539
Technetium Tc-99m pentetate, diagnostic, per study dose, up to 25 mCi
1/1/2024
Present
A9540
Technetium Tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 mCi
1/1/2024
Present
A9541
Technetium Tc-99m sulfur colloid, diagnostic, per study dose, up to 20 mCi
1/1/2024
Present
A9542
Indium In-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 mCi
1/1/2024
Present
A9546
Cobalt Co-57/58, cyanocobalamin, diagnostic, per study dose, up to 1 mcCi
1/1/2024
Present
A9550
Technetium Tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 mCi
1/1/2024
Present
A9553
Chromium Cr-51 sodium chromate, diagnostic, per study dose, up to 250 mcCi
1/1/2024
Present
A9557
Technetium Tc-99m bicisate, diagnostic, per study dose, up to 25 mCi
1/1/2024
Present
A9559
Cobalt Co-57 cyanocobalamin, oral, diagnostic, per study dose, up to 1 mcCi
1/1/2024
Present
A9560
Technetium Tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 mCi
1/1/2024
Present
A9561
Technetium Tc-99m oxidronate, diagnostic, per study dose, up to 30 mCi
1/1/2024
Present
A9562
Technetium Tc-99m mertiatide, diagnostic, per study dose, up to 15 mCi
1/1/2024
Present
A9563
Sodium phosphate P-32, therapeutic, per mCi
1/1/2024
Present
A9564
Chromic phosphate P-32 suspension, therapeutic, per mCi
1/1/2024
Present
A9566
Technetium Tc-99m fanolesomab, diagnostic, per study dose, up to 25 mCi
1/1/2024
Present
A9567
Technetium Tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 mCi
1/1/2024
Present
A9569
Technetium Tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
1/1/2024
Present
A9570
Indium In-111 labeled autologous white blood cells, diagnostic, per study dose
1/1/2024
Present
A9571
Indium In-111 labeled autologous platelets, diagnostic, per study dose
1/1/2024
Present
A9572
Indium In-111 pentetreotide, diagnostic, per study dose, up to 6 mCi
1/1/2024
Present
A9580
Sodium fluoride F-18, diagnostic, per study dose, up to 30 mCi
1/1/2024
Present
A9583
Injection, gadofosveset trisodium, 1 ml
1/1/2024
Present
A9586
Florbetapir F18, diagnostic, per study dose, up to 10 mCi
1/1/2024
Present
A9590
Iodine I-131, iobenguane, 1 mCi
1/1/2024
Present
A9597
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
1/1/2024
Present
A9598
Positron emission tomography radiopharmaceutical, diagnostic, for nontumor identification, not otherwise classified
1/1/2024
Present
A9601
Flortaucipir F 18 injection, diagnostic, 1 mCi
1/1/2024
Present
A9602
Fluorodopa f-18, diagnostic, per mCi
1/1/2024
Present
A9603
Injection, pafolacianine, 0.1 mg
1/1/2024
Present
A9609
Fludeoxyglucose f18 up to 15 millicuries
1/1/2024
Present
A9697
Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose
1/1/2024
Present
A9698
Nonradioactive contrast imaging material, not otherwise classified, per study
1/1/2024
Present
A9700
Supply of injectable contrast material for use in echocardiography, per study
1/1/2024
Present
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