Molybdenum-99 for Medical Imaging (2016)

Chapter: Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses

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Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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Appendix D

List of Radiopharmaceuticals and Associated Codes Used in the Committee’s Medicare Data and Nuclear Pharmacy Data Analyses

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Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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All Nuclear Medicine Diagnostic HCPCS Category
All Tc-99m diagnostic Tc-99m MPI diagnostic All non-Tc-99m/non-PET diagnostic All PET diagnostic Nuclear medicine diagnostic (non-PET)
Sestamibi (Cardiolite) A9500 X X X
Tetrofosmin (Myoview) A9502 X X X
Tl-201 chloride A9505 X X
N-13 ammonia A9526 X
Rb-82, diagnostic, per study dose to 60 mCi A9555 X
Medronate (MDP) A9503 X X
Tc-99m Oxidronate (TechneScan, HDP) A9561 X X
Pyrophosphate A9538 X X
Sodium fluoride F-18, diagnostic, per study dose, up to 30 millicuries A9580 X
Disofenin (Hepatolite) A9510 X X
Mebrofenin (Choletec) A9537 X X
Mertiatide (MAG-3) A9562 X X
Succimer (DMSA) A9551 X X
Tc-99m glucoheptonate (glucoheptate) A9550 X X
Tc-99m pentatate (DTPA) A9539 X X
I-125 sodium iothalamate (Glofil-125) A9554 X X
I-123 NaI, per 100 uCi, capsules, diagnostic A9516 X X
Page 239 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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I-123 NaI per mCi, diagnostic A9509 X X
I-131 NaI capsule per mCi, diagnostic A9528 X X
I-131 NaI solution per mCi, diagnostic A9529 X X
I-131 NaI per uCi A9531 X X
Pertechnetate per mCi A9512 X X
Macroaggregated albumin (MAA) A9540 X X
Xe-133 A9558 X X
Tc-99m pentatate aerosol A9567 X X
In-111 pentetreotide (Octreoscan) A9565/9572 X X
I-131 iobenguane (MIBG), diagnostic, per 0.5 mCi A9508 X X
I -123 iobenguane MIBG, diagnostic, up to 15 mCi A9582 X X
Fluorodeoxyglucose F-18 FDG, diagnostic A9552 X
Exametazime (Ceretec) A9521 X X
Bicisate (Neurolite) A9557 X X X
I-123 ioflupane (DATscan) A9584 X
In-111 Pentetate, Diagnostic CSF, per 0.5 mCi A9548 X
F18 Florbetapir (Amyvid) A9586 X
In-111 oxyquinoline (oxine) A9547 X X
Exametazime (HMPAO) autologous WBC’s A9569 X X
Page 240 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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All Nuclear Medicine Diagnostic HCPCS Category
All Tc-99m diagnostic Tc-99m MPI diagnostic All non-Tc-99m/non-PET diagnostic All PET diagnostic Nuclear medicine diagnostic (non-PET)
In-111 labeled autologous WBC’s A9570 X
Sulfur colloid A9541 X X
Labeled red cells A9560 X X
Ga-67 citrate per mCi A9556 X X
In-111 ibiritumomab tiuxetan (Zevalin), diagnostic A9542 X X
I-131 tositumomab (Bexxar), diagnostic A9544 X X
Co57/58 cyanocobalamin A9546 X X
Cr-51 sodium chromate A9553 X X
Co-57 cyanocobalamin A9559 X X
Arcitumomab (CEA Scan) A9568 X X
In-111 capromab pendetide (Prostascint) A9507 X X
In-111 labeled autologous platelets A9571 X X
I-131 human serum albumin A9524 X X

NOTE: Categories correspond to the labels used in Figures 6.1-6.3 and 6.6 and 6.7 in Chapter 6.

Page 237 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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Page 237
Page 238 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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Page 238
Page 239 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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Page 239
Page 240 Cite Bookmark
Suggested Citation: "Appendix D: List of Radiopharmaceuticals and Associated Codes Used in the Committee's Medicare Data and Nuclear Pharmacy Data Analyses." National Academies of Sciences, Engineering, and Medicine. 2016. Molybdenum-99 for Medical Imaging. Washington, DC: The National Academies Press. doi: 10.17226/23563.
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Next Chapter: Appendix E: Acronyms
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