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Official Description

Iodine i-131, iobenguane, 1 millicurie
Short Descr Iodine i-131 iobenguane 1mci
Related Drugs Azedra
Coverage Carrier Priced
Pricing Indicator(s) 51 – Drugs
MPI A – Not applicable, as HCPCS priced under one methodology
ASC Payment Group Code YY – 1/01/2020
BETOS I1E – Standard imaging - nuclear medicine
TOS Code(s) 4 – Diagnostic radiology
Added Date 1/1/2020
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
ASC Payment Indicator Packaged service/item; no separate payment made.
MUE 675
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2020-01-01 Added Code added.
Code
Description
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