HCPCS code A9575 — Inj gadoterate meglumi 0.1ml. Status: Active. Effective Jan 1, 2014. Source: CMS HCPCS Level II.

A9575

Active

Inj gadoterate meglumi 0.1ml

Injection, gadoterate meglumine, 0.1 ml

Category: Transportation & Supplies
Section: A-codes: Transportation, Medical & Surgical Supplies
Effective: Jan 1, 2014
Code type: alphanumeric
OPPS Status: N — Items / services packaged into APC rates

MUE — Medically Unlikely Edits

Maximum units of A9575 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 300
Practitioner Services 300

Source: CMS Medicare NCCI Medically Unlikely Edits

NDC Crosswalk

National Drug Codes (NDCs) mapped to this HCPCS code.

NDC Drug Name
00407-2943-01 Clariscan
00407-2943-02 Clariscan
00407-2943-05 Clariscan
00407-2943-06 Gadoterate Meglumine
00407-2943-12 Gadoterate Meglumine
00407-2943-17 Gadoterate Meglumine
00407-2943-22 Gadoterate Meglumine
00407-2943-70 Gadoterate Meglumine
65219-0080-05 Gadoterate Meglumine
65219-0082-10 Gadoterate Meglumine
65219-0084-15 Gadoterate Meglumine
65219-0086-20 Gadoterate Meglumine
65219-0088-50 Gadoterate Meglumine
67684-2000-00 Dotarem
67684-2000-01 Dotarem
67684-2000-05 Dotarem
67684-2000-06 Dotarem
67684-2001-00 Dotarem
67684-2001-01 Dotarem
67684-2001-02 Dotarem