Radiology Coding Alert

Question: If the physician documents 0.2 cc of gadolinium, can we report 1 unit of A9579, which specifies "per ml"?

Answer: Yes. Under Medicare rules, you should round up the dosage to the next reportable unit.

Official version: "When the dosage amount is less than the amount indicated for the HCPCS code, use 1 as the unit of measure," according to Medicare Claims Processing Manual (MCPM), chapter 17, section 70 (www.cms.hhs.gov/Manuals).

Code A9579 (Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified [NOS], per ml) specifies "per ml." One cc (cubic centimeter) is the same as 1 ml (milliliter), so the physician administered 0.2 ml of gadolinium. The 0.2 ml administered is less than the amount indicated for the HCPCS code (1 ml), so you should report 1 unit.