HCPCS Code Q9966: Low Osmolar Contrast Material, 200–299 mg/mL Iodine Concentration, Per mL

Getting your claims rejected? Improve your billing accuracy today by reading our guide on HCPCS Code Q9966, with billing and documentation tips.

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## **What is HCPCS code Q9966?** HCPCS Code Q9966 refers to "Low osmolar contrast material, 200-299 mg iodine per ml." This code is part of the Level II HCPCS system maintained by CMS fall under Contrast Agents/Diagnostic Imaging. Low osmolar contrast materials are used in diagnostic imaging exams to improve the visibility of vascular structures and organs. The code Q9966 specifically identifies the iodine concentration range of 200-299 mg/ml in such contrast agents. Providers use this code when billing for these contrast media used during imaging, such as CT scans or angiography. The code facilitates standardized claims processing by Medicare and other health insurers for these diagnostic supplies. It helps distinguish it from other contrast agent concentrations coded separately, such as Q9965 for 100-199 mg/ml or Q9967 for 300-399 mg/ml iodine concentration. The existence of this HCPCS Level II code enables clear identification of the specific type and concentration of contrast material administered in imaging contexts.

## **HCPCS code Q9966 documentation requirements** - The medical record should include the clinical rationale for using contrast material consistent with the imaging procedure’s appropriateness. - The exact contrast material volume (in mL) administered should be documented. - The type of administration route (e.g. intravenous, intra-arterial) and the imaging study performed should be identified. - If relevant, patient-specific factors (e.g. prior contrast allergy, renal function) may be noted, as part of routine imaging documentation. - The ordering physician and performing provider should be clearly documented in relation to the imaging service. These are standard expectations in radiology documentation; Medicare does not require separate documentation rules specific to Q9966 beyond supporting the imaging service.

## **HCPCS code Q9966 billing requirements** - Q9966 is reported on claims to reflect the contrast supply used in the imaging service. - Under Medicare’s Outpatient Prospective Payment System (OPPS), contrast agents (including Q9966) are classified as packaged items and their cost is included in the payment for the associated imaging procedure. CMS continues to package all contrast agents that do not exceed the daily cost threshold. - Q9966 is not separately reimbursable under OPPS; no independent payment is made for contrast when billed with the imaging procedure. - Under the Physician Fee Schedule (PFS), contrast codes like Q9966 are likewise not separately payable, as the supply cost is considered part of the procedure payment. - A provider should not bill Q9966 under revenue code 0255 when bundled with the imaging procedure. - In institutional settings (e.g. skilled nursing facilities) that bill separately for contrast, revenue code 0636 (Drugs requiring detailed coding) may be used, consistent with Medicare’s claims processing manual.

## **Other relevant codes** Other relevant HCPCS codes related to Q9966 (Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml) include: - **Q9965**: Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml - **Q9967**: Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml - **Q9959**: High osmolar contrast material, 150-199 mg/ml iodine concentration, per ml - **Q9960**: High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml - **Q9961**: High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml - **Q9962**: High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml - **Q9963**: High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml - **Q9964**: High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml These codes identify different concentrations of low or high osmolar contrast materials used in diagnostic imaging, facilitating precise billing and reimbursement distinct from Q9966.

Frequently asked questions

It is a code for low osmolar contrast material with 200-299 mg/ml iodine concentration, billed per mL for use in diagnostic imaging procedures.

No. Medicare does not separately reimburse Q9966 because contrast material is typically included in the payment for the imaging procedure. Separate payment is generally not allowed, it is not payable as a separate line item.

Q9967 designates low osmolar contrast material with iodine concentration of 300–399 mg/mL, distinct from the 200–299 mg/mL range of Q9966.