Radiology Coding Alert

Knowing when and how to report various level II or HCPCS Codes is crucial if freestanding imaging centers and independent diagnostic testing facilities are to receive speedy and appropriate reimbursement for the medical supplies they provide. Radiology coders in freestanding and independent facilities may often report medical supplies purchased, as long as carrier restrictions are met.

In my experience working with radiology coders, how to properly assign the codes listed in the Supplies for Radiologic Procedures section of the HCPCS Manual is always a topic for discussion, says Cindy Parman, CPC, CPC-H, co-owner of Coding Strategies Inc, an Atlanta-based firm that supports 1,000 radiologists and 350 physicians from other specialty areas. Fortunately, there are a number of resources that can help coders find the answers they need.

The Supplies for Radiologic Procedures section contains a number of codes that freestanding and independent facilities may use, including:

A4641 supply of radiopharmaceutical diagnostic imaging agent, not otherwise classified

A4642 supply of satumomab pendetide, radiopharmaceutical diagnostic imaging agent, per dose

A4643 supply of additional high dose contrast material(s) during magnetic resonance imaging, e.g., gadoteridol injection

A4644 supply of low osmolar contrast material (100-199 mg of iodine)

A4645 supply of low osmolar contrast material (200-299 mg of iodine)

A4646 supply of low osmolar contrast material (300-399 mg of iodine)

A4647 supply of paramagnetic contrast material (e.g., gadolinium)

A4649 surgical supply; miscellaneous

A9500 supply of radiopharmaceutical diagnostic imaging agent, technetium Tc 99m sestamibi, per dose

A9502 supply of radiopharmaceutical diagnostic imaging agent, technetium Tc 99m tetrofosmin, per unit dose

A9503 supply of radiopharmaceutical diagnostic imaging agent, technetium Tc 99m, medronate, up to 30 mCi

A9504 supply of radiopharmaceutical diagnostic imaging agent, technetium Tc 99m apcitide

A9505 supply of radiopharmaceutical diagnostic imaging agent, thallous chloride TL-201, per mCi

A9507 supply of radiopharmaceutical diagnostic imaging agent, indium IN 111 capromab pendetide, per dose

A9600 supply of therapeutic radiopharmaceutical, strontium-89 chloride, per mCi

A9605 supply of therapeutic radiopharmaceutical, samarium sm 153 lexidronamm, 50 mCi

Note: For a comprehensive list of Level II radiopharmaceuticals, see the Nov. 16, 2000, Federal Register.

When considering whether to report any of these supplies, Parman says, coders must first look at who purchased them. Only the entity that bears the cost of purchasing supplies may bill for them. Radiologists who practice in a hospital setting, for instance, would not bill for these [...]