HCPCS Code A9502: Technetium Tc-99m Tetrofosmin, Diagnostic, Per Study Dose

Learn about the HCPCS code A9502 for "technetium tc-99m tetrofosmin, diagnostic, per study dose" through this guide.

## **What is the HCPCS code A9502 for?** The HCPCS code A9502 is under the category Diagnostic and Therapeutic Pharmaceuticals. A9502 designates the provision of technetium tc-99m tetrofosmin, which is a diagnostic agent (also known as a radiopharmaceutical). It is administered before a diagnostic exam for the heart/stress tests. This radioactive material creates detailed images of the heart, which helps healthcare professionals assess and evaluate the heart during rest and stress conditions. This is used primarily in myocardial perfusion imaging (MPI) to evaluate myocardial blood flow both at rest and stress. It's also used on patients with the following symptoms characteristic of heart problems: - Shortness of breath - Fatigue - Chest pain - If they have coronary artery disease, or are suspected of having it - If they are undergoing pre-surgery evaluations for the heart

## **Documentation requirements for A9502** As with any HCPCS code, you'll need to have sufficient documentation that satisfies your insurer's coding guidelines, requirements, related policy articles, and local coverage determinations. Here are examples of what you need: - The full name of the patient - The full names and credentials of the healthcare professionals providing patient care and conducting tests - The name, address, and type of facility where this substance was administered - The relevant information and indications related to your patient's medical record and current condition (e.g., suspected coronary artery disease) - Types of imaging procedures conducted (e.g., stress/rest myocardial perfusion) - Dosage and administration details (millicuries per dose, single or multiple doses, if applicable) - Radiopharmaceutical lot number and manufacturer (per compliance requirements) - Documentation must include whether the study involved one or two administrations (e.g., rest and stress phases

## **Billing requirements for A9502** Besides the documentation requirements above, please take note of or have the following: - - 1 study dose = 1 unit - If the radiopharmaceutical is used in both rest and stress components of a myocardial perfusion imaging study, 2 units should be billed - Do not bill separately for each injection if both rest and stress phases are performed in the same study - This is billed separately from the imaging test(s) conducted - Speaking of imaging tests, please use the applicable CPT code for the tests conducted - Use the necessary ICD codes applicable to your patient's condition - This is generally covered by Medicare so long as medical necessity is justified for diagnostic imaging - If invoices or additional documentation are required for claims, providers should note “documentation available upon request” in the claim submission - The code must be submitted alongside the appropriate nuclear medicine procedure CPT codes (for example, 78451–78454) on the same claim and with consistent dates of service for accuracy and compliance - If treatment plans have been made, document the progress

## **Other similar codes** - **A9500** - Technetium tc-99m sestamibi, diagnostic, per study dose - **A9501** - Technetium tc-99m teboroxime, diagnostic, per study dose - **A9503** - Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries - **A9504** - Technetium tc-99m apcitide, diagnostic, per study dose, up to 20 millicuries

Frequently asked questions

Two units—one for each phase, i.e., one for the rest study and one for the stress study—as the code is per study dose.

Yes. The radiopharmaceutical code must appear on the same claim as the imaging procedure code, with matching service dates for correct processing.

Yes. It's possible for the patient to be allergic to it. There will be pain and discomfort in the injection site. It's also possible for the patient to have arrhythmias or a heart attack, so you must monitor your patient and manage these ASAP if they occur.