Wiki Help with coding Omnipaque

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ray-adams@outlook.com

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I am an auditor for our coding denials.

I see where our coding team is coding Q9967 for Omnipaque 350, but the 100mlis only being administered. Would that be coded to Q9965? Because only 100ml was used..
 
Q9967 is the correct HCPCS code. Code is based on mg/ml of iodine, not total ml administered to the patient. Correct billing would be Q9967 x 100 units.

Patricia Murrin, CPC, RCC
 
Q9967 is billed by # of ml given to patient. If patient is given 100 ml, then Q9967 is billed x 100 units. The 350 in the name of the contrast is the # of mg per ml of contrast material. Q9965 would be used if the concentration of iodine was between 100-199 mg per ml. Q9967 is used for contrast material containing 300-399 mg per ml, so in the case of Omnipaque 350, Q9967 is correct. Q9966 would be used for concentrations of 200-299 mg per ml.
 
Thank you.

greatbiller said:
Q9967 is billed by # of ml given to patient. If patient is given 100 ml, then Q9967 is billed x 100 units. The 350 in the name of the contrast is the # of mg per ml of contrast material. Q9965 would be used if the concentration of iodine was between 100-199 mg per ml. Q9967 is used for contrast material containing 300-399 mg per ml, so in the case of Omnipaque 350, Q9967 is correct. Q9966 would be used for concentrations of 200-299 mg per ml.
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Thank you for your help. I appreciate you replying. :D
 
greatbiller...Where did you get your information from on the billing of Q9967? I'm asking as I am running into some similar issues.
 
greatbiller said:
Q9967 is billed by # of ml given to patient. If patient is given 100 ml, then Q9967 is billed x 100 units. The 350 in the name of the contrast is the # of mg per ml of contrast material. Q9965 would be used if the concentration of iodine was between 100-199 mg per ml. Q9967 is used for contrast material containing 300-399 mg per ml, so in the case of Omnipaque 350, Q9967 is correct. Q9966 would be used for concentrations of 200-299 mg per ml.
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To make sure I understand this correctly. If there was 175 ml/cc given of this contrast (Omnipaque 350) then it would be Q9967 x 175 units?
 
I am having issues with Q9966, my provider uses 1 ml of Omnipaque 240, from what I am reading I would bill for 240 units or 1ml?
 
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Q9966 Code Description: Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml

Are you really only using one ml? As I understand it, the concentration of omnipaque you are using is 240 mg/ml, which is why you are HCPCS code Q9966. The actual volume in ml given is the units you will bill. So if you're using 10 ml of Omnipaque 240, you're billing Q9966 x 10. If you're only using one ml, bill x 1. But I would verify the actual volume. Dosing varies by the body area being imaged, for instance GI imaging can vary from 10 ml to 50 ml, herniography typically uses 50 ml, etc.

We used Isovue 300 and patients typically received 100 ml so we billed Q9967 x 100.
 
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