## **What is low osmolar contrast material?**
Q9967 reports low-osmolar iodinated contrast media with an iodine concentration between 300 and 399 mg/mL, billed per mL administered. Contrast material is a radiology supply injected to opacify vessels and organs so that clinicians can see anatomy during a CT or other imaging procedure. “Low-osmolar” means the agent’s osmolality is closer to plasma than older high-osmolar agents, which improves tolerability for the patient.
Common products in this range include Omnipaque 300/350, Isovue 300/370, Optiray 320, and Ultravist 300. Radiology teams perform intravenous injection in the office or hospital outpatient department as part of diagnostic imaging services.
## **Q9967 documentation requirements**
Strong charting supports clean claims and appropriate reimbursement.
### **Volume and units**
Record the exact volume administered in milliliters. Bill one Q9967 unit for each milliliter given (for example, 100 mL equals 100 units you bill).
### **Product identity and concentration**
Document trade name, concentration confirming 300–399 mg/mL, lot number, and expiration date to validate code selection.
### **Linked imaging service and indication**
Reference the paired imaging code (for example, CT with contrast) and the clinical reason for contrast use.
### **Site of service and payment status**
Indicate whether the setting is office or hospital outpatient. Under Medicare OPPS, contrast is often packaged, yet Q9967 still belongs on the claim for rate-setting even when not separately covered.
### **Safety and administration details**
Include IV access details, injection timing and route, and any monitoring notes. Capture allergy history or renal risk screening per local policy.
## **Q9967 billing requirements**
Align what you bill with what you documented.
### **Units-per-mL rule**
Report Q9967 strictly by the mL administered. Units must match the charted volume without rounding up.
### **Pair with the imaging code**
List the appropriate CPT for the exam in addition to Q9967 so the payer can adjudicate the complete service package.
### **OPPS bundling awareness**
For Medicare hospital outpatient claims, contrast is frequently packaged into the imaging APC. Submit Q9967 anyway because CMS uses it for cost work and rate-setting.
### **Wastage reporting (when applicable)**
If your payer requires wastage reporting from single-dose containers, append the correct wastage modifier and document discarded volume. Follow MAC instructions for JW/JZ when they apply.
### **Program and payer rules**
Check payer manuals for prior authorization triggers, unit thresholds, and recommended narrative elements (for example, brand and concentration).
## **Q9967 applicable modifiers**
Use only the modifiers your payer specifies for contrast supplies:
- JW: Discarded amount from a single-dose container, when the payer requires wastage reporting.
- JZ: Zero drug wasted, when the entire container was used and attestation is required.
- UD: Program- or state-specific designation when instructed by the payer.
26 and TC apply to radiology professional/technical components but are appended to the imaging CPT code, not to Q9967 itself.
## **Other relevant codes**
Choose the contrast code that matches the actual concentration, and submit the imaging CPT in tandem.
- Q9965: Low-osmolar contrast material, 100-199 mg/mL iodine.
- Q9966: Low-osmolar contrast, 200–299 mg/mL iodine, per mL.
- Q9968: Non-radioactive visualization adjunct, per mg (for example, methylene blue).
Examples of paired CT CPT codes with contrast:
- 70460: CT head with contrast
- 71260: CT chest with contrast
- 74160: CT abdomen with contrast
- 74177: CT abdomen and pelvis with contrast
Frequently asked questions
