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Code deleted, see A9589.

Official Description

Injection, hexaminolevulinate hydrochloride, 100 mg, per study dose
Short Descr Hexaminolevulinate hcl
Related Drugs CYSVIEW
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(t)
Cross-Reference(s) A9589
BETOS O1E – Other drugs
TOS Code(s) 4 – Diagnostic radiology
Added Date 1/1/2011
Termination Date 12/31/2018
APC Status Indicator Items and Services Packaged into APC Rates
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 240 - Medications (Injections, infusions and other forms)
Date
Action
Notes
2018-12-31 Deleted Code deleted, see A9589.
2011-01-01 Added Added
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