A9513

Short Description

• Lutetium lu 177 dotatat ther

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2019

HCPCS Code Added Date

• January 01, 2019

HCPCS Pricing Indicator Code

• 57 = Other carrier priced

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Coverage Issues Manual Reference Section Number

• 153.60

HCPCS ASC Payment Group Code

• YY

HCPCS ASC Payment Group Effective Date

• January 01, 2019

HCPCS Type Of Service Code

• 6 = Therapeutic radiology

HCPCS Anesthesia Base Unit Quantity

• 0