HCPCS code A9538 — Tc99m pyrophosphate.
Status: Active.
Effective Jan 1, 2006.
Source: CMS HCPCS Level II.
A9538
ActiveTc99m pyrophosphate
Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries
Category:
Transportation & Supplies
Section:
A-codes: Transportation, Medical & Surgical Supplies
Effective:
Jan 1, 2006
Code type:
alphanumeric
OPPS Status:
N
— Items / services packaged into APC rates
MUE — Medically Unlikely Edits
Maximum units of A9538 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with A9538 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| A9512 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)